[Sepsis in out-of-hospital emergency medicine].
Sepsis in der prähospitalen Notfallmedizin: Was können prähospital Tätige aus der Surviving Sepsis Campaign und S3-Leitlinie ziehen?
Antiinfectives
Emergency medical services
Focus
Infections
Septic shock
Journal
Notfall & rettungsmedizin
ISSN: 1434-6222
Titre abrégé: Notf Rett Med
Pays: Germany
ID NLM: 9812553
Informations de publication
Date de publication:
2022
2022
Historique:
accepted:
06
09
2021
pubmed:
24
11
2021
medline:
24
11
2021
entrez:
23
11
2021
Statut:
ppublish
Résumé
Sepsis is a challenge in emergency medicine, as this life-threatening organ dysfunction, caused by a dysregulated host response to an infection, presents manifold and therefore is often recognized too late. Recently published surviving sepsis campaign and German S3 guidelines provide recommendations for diagnosis and therapy of sepsis in an in-hospital or intensive care setting, but do not particularly address out-of-hospital emergency medical care. We aim to work out the evidence base with regard to the out-of-hospital care of patients with suspected sepsis and to derive treatment recommendations for emergency medical services. Therapy of sepsis and septic shock is summarized in bundles, whereby the first bundle should ideally be completed within the first hour-in analogy to "golden hour" concepts in other emergency medical entities, such as trauma care. In the out-of-hospital setting, therapy focuses on securing vital parameters, according to the ABCDE scheme, with a particular focus on volume therapy. Further procedures within the 1 h bundle, such as lactate measurement, obtaining microbiological samples, and starting an anti-infective therapy, are broadly available in hospital only. The aim is to control the site of infection as soon as possible. Therefore, an appropriate designated hospital should be chosen carefully and informed in advance, in order to initiate and pave the way for further clinical diagnostic and treatment paths. Moreover, structured and target-oriented handovers, as well as regular training, are required.
Sections du résumé
Background
UNASSIGNED
Sepsis is a challenge in emergency medicine, as this life-threatening organ dysfunction, caused by a dysregulated host response to an infection, presents manifold and therefore is often recognized too late.
Objectives
UNASSIGNED
Recently published surviving sepsis campaign and German S3 guidelines provide recommendations for diagnosis and therapy of sepsis in an in-hospital or intensive care setting, but do not particularly address out-of-hospital emergency medical care. We aim to work out the evidence base with regard to the out-of-hospital care of patients with suspected sepsis and to derive treatment recommendations for emergency medical services.
Conclusions
UNASSIGNED
Therapy of sepsis and septic shock is summarized in bundles, whereby the first bundle should ideally be completed within the first hour-in analogy to "golden hour" concepts in other emergency medical entities, such as trauma care. In the out-of-hospital setting, therapy focuses on securing vital parameters, according to the ABCDE scheme, with a particular focus on volume therapy. Further procedures within the 1 h bundle, such as lactate measurement, obtaining microbiological samples, and starting an anti-infective therapy, are broadly available in hospital only. The aim is to control the site of infection as soon as possible. Therefore, an appropriate designated hospital should be chosen carefully and informed in advance, in order to initiate and pave the way for further clinical diagnostic and treatment paths. Moreover, structured and target-oriented handovers, as well as regular training, are required.
Identifiants
pubmed: 34812248
doi: 10.1007/s10049-021-00949-y
pii: 949
pmc: PMC8597546
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Pagination
541-551Informations de copyright
© The Author(s) 2021.
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