Early proactive diagnosis and treatment algorithm for sepsis from the perspective of the Royal College of General Practitioners and the Surviving Sepsis Campaign (2021)
This paper presents a diagnosis of the likely risk of sepsis using the National Early Warning Score (NEWS2). According to the UK National Health Service and the Royal College of General Practitioners, sepsis should be suspected and immediate intensive care should be considered if a patient has NEWS...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Zaslavsky O.Yu.
2022-06-01
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| Series: | Медицина неотложных состояний |
| Subjects: | |
| Online Access: | https://emergency.zaslavsky.com.ua/index.php/journal/article/view/1500 |
| Summary: | This paper presents a diagnosis of the likely risk of sepsis using the National Early Warning Score (NEWS2). According to the UK National Health Service and the Royal College of General Practitioners, sepsis should be suspected and immediate intensive care should be considered if a patient has NEWS2 score of 5 or more, or if the patient has NEWS2 score of 3 or more: non-blanching rash, mottled/ashen/cyanotic skin; responds only to voice/pain or does not respond; no urination in the last 18 hours or diuresis less than 0.5 ml/kg on catheterization; serum lactate more than 2 mmol/l. The measures to be taken within the first hour of a diagnosis of the likely risk of sepsis are outlined, as well as criteria for the lack of their effectiveness; the main goals of intensive care in sepsis: identification and control of foci of infection; antibiotic therapy, fluid resuscitation, additional oxygen supply; recommended parameters for continuous or half-hour monitoring of patients with sepsis who are at high risk of deterioration; blocks of intensive care, which should be initiated only by specialists experienced in sepsis management. The indicators of hospital lethality depending on the level of blood serum lactate are given: less than 2 mmol/l — 15 %, from 2.1 to 3.9 mmol/l — 25 %, more than 4 mmol/l — 38 %. The presented algorithm is fully consistent with the Surviving Sepsis Campaign guidelines (2021). |
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| ISSN: | 2224-0586 2307-1230 |