Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Noninvasive Management of Sepsis

By ACEP Now | on April 1, 2012 | 0 Comment
CME CME Now
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Online CME Questionnaire

The CME test and evaluation form based on this article are located online at www.ACEP.org/focuson.

You Might Also Like
  • Inferior Vena Cava Ultrasound
  • Sepsis in Pregnancy
  • Noninvasive Positive Pressure Ventilation In the Emergency Department
Explore This Issue
ACEP News: Vol 31 – No 04 – April 2012

The participant should, in order, review the learning objectives, read the article, and complete the CME post-test/evaluation form to receive credit. It should take approximately 1 hour to complete. You will be able to print your CME certificate immediately. The credit for this CME activity is available through April 30, 2015.

The management of sepsis requires a life-saving set of skills that emergency physicians are increasingly relied upon to possess at expert-level competency. While many iterations of sepsis management have emerged in the literature, this article will focus on noninvasive management of sepsis by reviewing the epidemiology and evolution of sepsis and sepsis care, as well as highlighting the indications, contraindications, and benefits of non­invasive management of sepsis.

Epidemiology

Sepsis is the most expensive disease in the United States, costing the health care system approximately $50 billion annually.1 Sepsis is the number 10 cause of mortality.2 A large epidemiological study in 2001 placed the annual incidence at approximately 750,000 cases per year, with a mortality of 20%-30%.3 Sepsis disproportionately affects the elderly, with a 13-fold increase in relative risk for those older than 65. This same age group represents approximately 65% of total cases of sepsis.2 With our aging population and increasing life expectancy, the emergency physician has the potential to have considerable impact on the care of this disease process.

Table 1. SIRS Criteria

  • Temperature >38°C or <36°C
  • Heart rate >90 beats/min
  • Tachypnea (respiratory rate >20 breaths/min) or PaCO2 <32 mm Hg
  • WBC >12,000 cells/microL or <4,000 cells/microL

Definition

Sepsis was originally described as the presence of an infectious source plus at least two systemic inflammatory response syndrome (SIRS) criteria (Table 1). Severe sepsis was defined as sepsis with evidence of organ dysfunction. Septic shock is sepsis with hypotension.4 An updated definition of sepsis identifies this disease process as an infection plus some of a larger set of criteria that includes traditional SIRS criteria, as well as other markers of hemodynamic instability, inflammation, and organ dysfunction4 (Table 2).

Evolution of Bundled Therapy

Combining multiple evidence-based treatments in a standardized, bundled approach to sepsis has been discussed since 1976. A study of sepsis in a dog model identified a synergistic effect of fluid resuscitation plus antibiotics.5 In 2001, Dr. Rivers demonstrated that an early, algorithmic application of antibiotics, source control, volume resuscitation, vasopressors for those still in shock, and transfusion in the anemic significantly lowered both mortality and resource utilization.6

Pages: 1 2 3 4 5 6 | Single Page

Topics: AntibioticCMEDiagnosisEducationEmergency MedicineEmergency PhysicianInfectious DiseaseProcedures and SkillsResearchUltrasound

Related

  • Dr. Joe Sachs and “The Pitt” Redefine Public Health Education Through Storytelling

    July 3, 2025 - 0 Comment
  • Reflecting on Four Decades at ACEP’s Council

    June 28, 2025 - 0 Comment
  • 10 Essentials for Your Emergency Department Fanny Pack

    June 17, 2025 - 0 Comment

Current Issue

ACEP Now: July 2025

Download PDF

Read More

About the Author

ACEP Now

View this author's posts »

No Responses to “Noninvasive Management of Sepsis”

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603