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Critical care in the emergency department: severe sepsis and septic shock


Severe sepsis is a common and commonly fatal disease and is essentially an exaggerated inflammatory response. The epidemiology of severe sepsis and septic shock has been difficult to determine because of an inconsistent approach to definitions and diagnosis. Patients with sepsis account for approximately a third of hospital and intensive care unit bed days in the UK and mortality ranges from 25% to 80%. A number of interventions have recently been shown to improve outcomes. The Surviving Sepsis Campaign recommends a package of evidence based interventions known as the sepsis resuscitation bundles and the sepsis treatment bundles. The aim is to ensure that eligible patients receive all appropriate treatments in a timely fashion, utilising protocol driven prescriptions.

  • CVP, central venous pressure
  • DO2, oxygen delivery
  • ED, emergency department
  • EGDT, early goal directed therapy
  • GCS, Glasgow Coma Scale
  • ICU, intensive care unit
  • IV, intravenous
  • LOS, length of stay
  • MAP, mean arterial pressure
  • PA, pulmonary artery
  • RhAPC, recombinant human activated protein C
  • ScvO2, central venous oxygen saturation
  • SIRS, systemic inflammatory response syndrome
  • SvO2, mixed venous oxygen saturation
  • VO2, oxygen consumption
  • emergency department
  • sepsis
  • septic shock

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