Sepsis Management in the ICU

The EMGuideWire Team is visited by a prior crew member, Russell Trigonis, MD! Join them as they discuss how the patient diagnosed with Sepsis in your ED has their care continued in the ICU! Pearls Start pressors with IVF (30-40cc/kg). NE at 7mcg/min peripherally can always be stopped, but better earlier than later. Increase NE until at 20mcg/min, if still hypotensive, then add a 2nd pressor like Vasopressin at 0.03units/min and 100mg Hydrocortisone Q8h. Start antibiotics early and identify source. CXR, US lungs/abd, UA, CT abd should all be considered.  Procalcitonin is helpful for stopping abx. Doesn’t change ED treatment. Don’t order Vitamin C or thiamine in ED. -Travis Barlock, MD