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  • Review article: Sepsis in the emergency department - Part 3: Treatment

    Author(s)
    Williams, Julian M
    Keijzers, Gerben
    Macdonald, Stephen PJ
    Shetty, Amith
    Fraser, John F
    Griffith University Author(s)
    Keijzers, Gerben
    Fraser, John F.
    Year published
    2018
    Metadata
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    Abstract
    Although comprehensive guidelines for treatment of sepsis exist, current research continues to refine and revise several aspects of management. Imperatives for rapid administration of broad‐spectrum antibiotics for all patients with sepsis may not be supported by contemporary data. Many patients may be better served by a more judicious approach allowing consideration of investigation results and evidence‐based guidelines. Conventional fluid therapy has been challenged with early evidence supporting balanced, restricted fluid and early vasopressor use. Albumin, vasopressin and hydrocortisone have each been shown to support ...
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    Although comprehensive guidelines for treatment of sepsis exist, current research continues to refine and revise several aspects of management. Imperatives for rapid administration of broad‐spectrum antibiotics for all patients with sepsis may not be supported by contemporary data. Many patients may be better served by a more judicious approach allowing consideration of investigation results and evidence‐based guidelines. Conventional fluid therapy has been challenged with early evidence supporting balanced, restricted fluid and early vasopressor use. Albumin, vasopressin and hydrocortisone have each been shown to support blood pressure and reduce catecholamine requirements but without effect on mortality, and as such should be considered for ED patients with septic shock on a case‐by‐case basis. Measurement of quality care in sepsis should incorporate quality of blood cultures and guideline‐appropriateness of antibiotics, as well as timeliness of therapy. Local audit is an essential and effective means to improve practice. Multicentre consolidation of data through agreed minimum sepsis data sets would provide baseline quality data, required for the design and evaluation of interventions.
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    Journal Title
    Emergency Medicine Australasia
    Volume
    30
    Issue
    2
    DOI
    https://doi.org/10.1111/1742-6723.12951
    Subject
    Clinical Sciences not elsewhere classified
    Clinical Sciences
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/381054
    Collection
    • Journal articles

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