Management of suspected sepsis and septic shock in adults:


Sepsis is a clinical and life-threatening condition characterized by systemic inflammation due to infection. The sepsis severity is continuum ranging from sepsis to septic shock. 

Signs and symptoms:
The signs and symptoms include low body temperature, fever, increased heart rate, confusion, metabolic acidosis. The early sepsis signs are a rapid heart rate, high blood sugar and decreased urination. In case of sepsis, the drop in blood pressure may leads to shock. Some symptoms are also related to specific infection. Severe sepsis causing poor organ function or insufficient blood flow.

Cause:
Sepsis is caused by an immune response which is triggered by an infection. Most commonly, the infection is known by bacterial, but it may also be from fungi, viruses, or parasites. Common locations for the primary infection include lungs, brain, urinary tract, skin, and abdominal organs.

Sepsis is normally treated with intravenous fluids and antibiotics. Typically, antibiotics are given as soon as possible. Often, continuous care is performed in an intensive care unit. If fluid replacement is not enough to maintain blood pressure, medications that raise blood pressure may be used. To support the function of the lungs and kidneys, mechanical ventilation and dialysis may be required.
Diagnosis:

For proper management of sepsis, early diagnosis is necessary, because the initiation of rapid therapy is key to reducing deaths from severe sepsis. To bring attention to potential cases as early as possible, some hospitals use alerts generated from electronic health records.

Immediate Evaluation and management:
Correcting hypoxemia and Securing the airway and establishing venous access for the early administration of fluids and antibiotics are priorities in the management of patients with sepsis and septic shock.

Establish venous access: Supplemental oxygen should be supplied to all patients with sepsis and oxygenation should be monitored continuously with pulse oximetry. To support the increased work of breathing that typically accompanies sepsis, intubation and mechanical ventilation may be required.

Initial investigations: An initial brief history and examination, as well as laboratory, microbiologic, and imaging studies are often obtained simultaneously while access is being established and the airway stabilized. This brief assessment yields clues to the suspected source and complications of sepsis, and therefore, helps guide empiric therapy and additional testing.

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