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Open Access Highly Accessed Review

Initial Emergency Department Diagnosis and Management of Adult Patients with Severe Sepsis and Septic Shock

Sarah M Perman1, Munish Goyal2 and David F Gaieski13*

Author Affiliations

1 Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, USA

2 Department of Emergency Medicine, MedStar Washington Hospital Center; Georgetown University School of Medicine, Georgetown, USA

3 Center for Resuscitation Science, Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:41  doi:10.1186/1757-7241-20-41

Published: 27 June 2012

Abstract

Severe sepsis is a medical emergency affecting up to 18 million individuals world wide, with an annual incidence of 750,000 in North America alone. Mortality ranges between 28-50% of those individuals stricken by severe sepsis. Sepsis is a time critical illness, requiring early identification and prompt intervention in order to improve outcomes. This observation has led to increased awareness and education in the field of Emergency Medicine; it has also led to the implementation of critical interventions early in the course of patient management, specifically Early-Goal Directed Therapy, and rapid administration of appropriate antimicrobials. This review begins with a brief summary of the pathophysiology of sepsis, and then addresses the fundamental clinical aspects of ED identification and resuscitation of the septic patient.

Keywords:
Sepsis; Septic shock; Early-goal directed therapy; Resuscitation