Prolonged Field Care Podcast 50: Simple Sepsis Recognition And Intervention For PFC

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 less than 100

RR greater than 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.

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