Overwhelming sepsis

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Surviving Sepsis Campaign adult guidelines 2021 initial management septic shock official

Overwhelming sepsis is a medical emergency, usually meaning sepsis with organ dysfunction or septic shock.
If this is about someone right now, call emergency services or go to the nearest emergency department immediately, especially with any of these:
  • Confusion, extreme drowsiness, collapse, or difficulty waking
  • Fast or difficult breathing
  • Cold, mottled, blue, or clammy skin
  • Very low urine output
  • Persistent vomiting, severe weakness, or severe pain
  • Fever or abnormally low temperature with a suspected infection
  • Low blood pressure, fainting, or a rapid weak pulse
Do not wait for a clinic appointment, do not drive an unstable person yourself, and do not give food or drink if they are confused or may need urgent procedures.
Hospital treatment typically involves immediate assessment, blood cultures and lactate testing, rapid IV broad-spectrum antibiotics, IV crystalloid resuscitation, oxygen/ventilatory support as needed, prompt source control such as drainage or surgery, and vasopressors if blood pressure remains low. Current adult guidance targets prompt antibiotics, at least 30 mL/kg IV crystalloid within the first 3 hours for sepsis-induced hypoperfusion or septic shock, and an initial MAP target of about 65 mmHg when vasopressors are required, per the Surviving Sepsis Campaign guidance.
If you mean a specific patient, state their age, symptoms, suspected infection, blood pressure, temperature, pulse, oxygen saturation, and any lab values, but seek emergency care first.
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