Why do we care about sepsis in prolonged field care? What can we do about septic shock with what we are normally carrying on a deployment? How do you mix an epinephrine drip? Dr. Maves lays it all out in about 20 minutes.
Here are some of the resources and pearls he mentioned in the episode:
Infection plus organ dysfunction is sepsis
Infection plus hypotension is septic shock
Q-SOFA positive with 2 of the three and suggestive of sepsis:
Systolic BP <100
RR>22 breaths per minute
Presence of delirium
Earlier intervention is better than later
Higher mortality rate than poly trauma or myocardial infarction
Something is better than nothing
Septic shock is not purely distributive. You will also see myocardial depression loss of contractility, capillary leakage, microvascular obstruction from small thrombi and concomitant hypovolemia.
Some fluids are good but more fluids mat be dangerous
If 2 or 3 liters does not work it is unlikely that 5 or 6 fix hypovolemia. At some point it will start increasing mortality.
The best vasopressor is the one you have
Delaying proper antibiotics increases risk of death by 8% every hour.
IMAI district clinician manual: Hospital care for adolescents and adults…
For more Download the World Health Organization Manual for Integrated Management of Adolescent and Adult Illness:
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Now on to the podcast…