SEPSIS - EMERGENCY AND DIAGNOSTIC CHALLENGE IN OUT-HOSPITAL CONDITIONS
Keywords:
sepsis, SIRS score, qSOFA score
Abstract
Introduction/goal. Sepsis, by definition, is a life-threatening organ dysfunction caused by an inadequate response to infection. Earlier recognition and treatment improves outcome. The aim of the paper is to present a patient in whom the initial pre-hospital examination was suspected, and the diagnosis of sepsis was confirmed in hospital conditions, in order to draw attention to the symptomatology that patients can show in the case of sepsis. Case presentation. A patient suspected of having sepsis is shown. He was initially cared for in the field, with monitoring of vital parameters and adequate therapy, transported to an on-call health facility, where the diagnosis of sepsis was confirmed.
Conclusion. Timely recognition and treatment is the key to the survival of patients suffering from sepsis. If the treatment is carried out in the first hour from the onset of symptoms, the survival rate is over 80%, after six hours - only 30%.
References
1. Centers for Disease Control and Prevention. Sepsis. Available from: https://www.cdc.gov/sepsis/about/index.html
2. Sepsis and septic shock. National Clinical Guidelines, Ministry of Health of Montenegro, 2012. Available from: https://hitna.me/wp-content/uploads/2023/12/Nacionalni-vodi-Sepsa.pdf
3. Bumbaširević V, Veličković J, Palibrk I, Jovanović B, Avramović J. NOVINE U DIJAGNOSTICI I LEČENJU SEPSE I SEPTIČNOG ŠOKA (Novine u lečenju sepse). Serbian Journal of Anesthesia and Intensive Therapy. 2017; 17(1):171B. doi:10.5937/sjait1708171B
4. Bumbaširević V, Stanisavljević J, Veličković J, Hadžibegović A, Milenković M, Ivančević N. Sepsa i septični šok - rano prepoznaj, brzo deluj, leči ispravno. Srp Arh Celok Lek. 2020;148(7-8):497-502. doi: 10.2298/SARH200128040B
5. Kim HI, Park S. Sepsis: Early Recognition and Optimized Treatment. Tuberc Respir Dis (Seoul). 2019;82(1):6-14. doi: 10.4046/trd.2018.0041. Epub 2018 Sep 28. PMID: 30302954; PMCID: PMC6304323.
6. Cleveland Clinic. Sepsis. Available from: https://my.clevelandclinic.org/health/diseases/12361-sepsis
7. Gauer R, Forbes D, Boyer N. Sepsis: Diagnosis and Management. Am Fam Physician. 2020 Apr 1;101(7):409-418. PMID: 32227831.
8. Purcarea A, Sovaila S. Sepsis, a 2020 review for the internist. Rom J Intern Med. 2020;58(3):129-137. doi: 10.2478/rjim-2020-0012. PMID: 32396142.
9. Cleland DA, Eranki AP. Procalcitonin. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. PMID: 30969616.
10. Systemic Inflammatory Response Syndrome, National Center for Biotechnology Information, available at: https://www.ncbi.nlm.nih.gov/books/NBK547669/#:~:text=Objectively%2C%20SIRS%20is%20defined%20by,CO2%20less%20than%2032%20mmHg
11. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. doi: 10.1378/chest.101.6.1644.
12. Razvoj definicije sepse, Dinić N. et al. Serbian Journa of the edica hamber | Volume 4 / No. 1 | March 2023, DOI: 10.5937/smclk4-42608
13. Gavelli F, Castello LM, Avanzi GC. Management of sepsis and septic shock in the emergency department. Intern Emerg Med. 2021;16(6):1649-1661. doi: 10.1007/s11739-021-02735-7. Epub 2021 Apr 22. PMID: 33890208; PMCID: PMC8354945.
14. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45(3):486-552. doi: 10.1097/CCM.0000000000002255
15. Vincent JL. Current sepsis therapeutics. EBioMedicine. 2022;86:104318. doi: 10.1016/j.ebiom.2022.104318. Epub 2022 Dec 2. PMID: 36470828; PMCID: PMC9782815.
2. Sepsis and septic shock. National Clinical Guidelines, Ministry of Health of Montenegro, 2012. Available from: https://hitna.me/wp-content/uploads/2023/12/Nacionalni-vodi-Sepsa.pdf
3. Bumbaširević V, Veličković J, Palibrk I, Jovanović B, Avramović J. NOVINE U DIJAGNOSTICI I LEČENJU SEPSE I SEPTIČNOG ŠOKA (Novine u lečenju sepse). Serbian Journal of Anesthesia and Intensive Therapy. 2017; 17(1):171B. doi:10.5937/sjait1708171B
4. Bumbaširević V, Stanisavljević J, Veličković J, Hadžibegović A, Milenković M, Ivančević N. Sepsa i septični šok - rano prepoznaj, brzo deluj, leči ispravno. Srp Arh Celok Lek. 2020;148(7-8):497-502. doi: 10.2298/SARH200128040B
5. Kim HI, Park S. Sepsis: Early Recognition and Optimized Treatment. Tuberc Respir Dis (Seoul). 2019;82(1):6-14. doi: 10.4046/trd.2018.0041. Epub 2018 Sep 28. PMID: 30302954; PMCID: PMC6304323.
6. Cleveland Clinic. Sepsis. Available from: https://my.clevelandclinic.org/health/diseases/12361-sepsis
7. Gauer R, Forbes D, Boyer N. Sepsis: Diagnosis and Management. Am Fam Physician. 2020 Apr 1;101(7):409-418. PMID: 32227831.
8. Purcarea A, Sovaila S. Sepsis, a 2020 review for the internist. Rom J Intern Med. 2020;58(3):129-137. doi: 10.2478/rjim-2020-0012. PMID: 32396142.
9. Cleland DA, Eranki AP. Procalcitonin. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. PMID: 30969616.
10. Systemic Inflammatory Response Syndrome, National Center for Biotechnology Information, available at: https://www.ncbi.nlm.nih.gov/books/NBK547669/#:~:text=Objectively%2C%20SIRS%20is%20defined%20by,CO2%20less%20than%2032%20mmHg
11. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. doi: 10.1378/chest.101.6.1644.
12. Razvoj definicije sepse, Dinić N. et al. Serbian Journa of the edica hamber | Volume 4 / No. 1 | March 2023, DOI: 10.5937/smclk4-42608
13. Gavelli F, Castello LM, Avanzi GC. Management of sepsis and septic shock in the emergency department. Intern Emerg Med. 2021;16(6):1649-1661. doi: 10.1007/s11739-021-02735-7. Epub 2021 Apr 22. PMID: 33890208; PMCID: PMC8354945.
14. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45(3):486-552. doi: 10.1097/CCM.0000000000002255
15. Vincent JL. Current sepsis therapeutics. EBioMedicine. 2022;86:104318. doi: 10.1016/j.ebiom.2022.104318. Epub 2022 Dec 2. PMID: 36470828; PMCID: PMC9782815.
Published
2025/01/23
Section
Case report
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