scholarly journals Utility of the Early Lactate Area Score as a Prognostic Marker for Septic Shock Patients in the Emergency Department

2019 ◽  
Vol 34 (2) ◽  
pp. 126-132 ◽  
Author(s):  
Gina Yu ◽  
Seung Joon Yoo ◽  
Sang-Hun Lee ◽  
June Sung Kim ◽  
Sungmin Jung ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Prognostic Marker ◽  
Area Score

scholarly journals Management of sepsis and septic shock in the emergency department

2021 ◽  
Author(s):  
Francesco Gavelli ◽  
Luigi Mario Castello ◽  
Gian Carlo Avanzi
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Patient Management ◽  
Emergency Physicians ◽  
Surviving Sepsis Campaign ◽  
Sepsis Management ◽  
Early Management ◽  
New Information ◽  
Sepsis And Septic Shock ◽  
Early Phases

AbstractEarly management of sepsis and septic shock is crucial for patients’ prognosis. As the Emergency Department (ED) is the place where the first medical contact for septic patients is likely to occur, emergency physicians play an essential role in the early phases of patient management, which consists of accurate initial diagnosis, resuscitation, and early antibiotic treatment. Since the issuing of the Surviving Sepsis Campaign guidelines in 2016, several studies have been published on different aspects of sepsis management, adding a substantial amount of new information on the pathophysiology and treatment of sepsis and septic shock. In light of this emerging evidence, the present narrative review provides a comprehensive account of the recent advances in septic patient management in the ED.

Effect of Undertriage on the Outcomes of Cancer Patients with Febrile Neutropenia, Sepsis, and Septic Shock

2021 ◽  
pp. 105477382199968
Author(s):  
Anas Alsharawneh
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Length Of Stay ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Emergency Setting ◽  
Extended Length ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Timely Treatment

Sepsis and neutropenia are considered the primary life-threatening complications of cancer treatment and are the leading cause of hospitalization and death. The objective was to study whether patients with neutropenia, sepsis, and septic shock were identified appropriately at triage and receive timely treatment within the emergency setting. Also, we investigated the effect of undertriage on key treatment outcomes. We conducted a retrospective analysis of all accessible records of admitted adult cancer patients with febrile neutropenia, sepsis, and septic shock. Our results identified that the majority of patients were inappropriately triaged to less urgent triage categories. Patients’ undertriage significantly prolonged multiple emergency timeliness indicators and extended length of stay within the emergency department and hospital. These effects suggest that triage implementation must be objective, consistent, and accurate because of the several influences of the assigned triage scoring on treatment and health outcomes.

EVALUATION OF APACHE II, SAPS II, MPM II, AND MEDS FOR THE PROGNOSTICATION OF SEVERE SEPSIS OR SEPTIC SHOCK IN THE EMERGENCY DEPARTMENT.

2006 ◽  
Vol 34 ◽  
pp. A2 ◽  
Author(s):  
Thomas Cho ◽  
H Bryant Nguyen ◽  
Sean R Hayes ◽  
Laura Leistiko ◽  
Renee Schroetlin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Apache Ii ◽  
Saps Ii

Hypercoagulability in Septic Shock Patients With Thrombocytopenia

2021 ◽  
pp. 088506662110241
Author(s):  
Sang-Min Kim ◽  
Sang-Il Kim ◽  
Gina Yu ◽  
June-Sung Kim ◽  
Seok In Hong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Multivariate Analysis ◽  
Platelet Count ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Sofa Score ◽  
Odds Ratio ◽  
Fibrinogen Level ◽  
Limited Information

Background: Despite thrombocytopenia, patients with sepsis often experience hypercoagulability. However, limited information is available on the prevalence and effect of hypercoagulability in patients with sepsis-induced thrombocytopenia. Hence, we evaluated the prevalence of hypercoagulability and the association between hypercoagulability and clinical outcomes in septic shock patients with thrombocytopenia. Methods: Thromboelastography (TEG) was performed prospectively in 1294 patients with septic shock at the emergency department (ED) between January 2016 and December 2019. After excluding 405 patients who did not require resuscitation, refused enrollment, or developed septic shock after ED presentation, 889 patients were included. We defined thrombocytopenia as an admission platelet count lower than 150,000/µl according to SOFA score. We defined hypocoagulability and hypercoagulability as coagulation index (CI)< −3 and >3 on TEG, respectively. Results: Of the 889 septic shock patients (mean age 65.6 ± 12.7 years, 58.6% male), 473 (53.2%) had thrombocytopenia. Eighty-five (18.0%) patients showed hypercoagulable TEG and73 (15.4%) patients showed hypocoagulable TEG. The hypercoagulable TEG group had a significantly higher fibrinogen level and a lower 28-day mortality rate than the normal and hypocoagulable TEG groups (518 vs. 347 and 315 mg/dL; 7.1% vs. 21.1% and 36.8%, P < 0.01, respectively). In multivariate analysis, hypercoagulable TEG was associated with a decreased mortality rate (odds ratio: 0.395; 95% confidence interval, 0.162-0.965). Conclusions: In septic shock patients with thrombocytopenia, hypercoagulability was not uncommon. TEG can quickly distinguish the hypercoagulability and hypocoagulability states and serve as a valuable tool for evaluating the degree and risk in septic shock patients with thrombocytopenia.

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