Sepsis - Interventions that do / do not improve outcomes

Do:

- Have high index of suspicion and understand those at risk 

- Take a history - understand confirmation and fixation bias - what is the likely source 

- Have a sepsis pathway or protocol 

- Have a rapid response team who know what they are doing 

- Give (not prescribe) antibiotics now if you think patient has bacterial sepsis 

- Talk to others - infectious disease specialists, surgeons, your team - especially your team 

- Pay nurses well, pay ICU doctors well - have enough of both 

- Consider corticosteroids for persistent septic shock 

- Understand late mortality 

- Enroll patient in a clinical trial 



Don't Know / Doesn't Matter:

- Immune stimulation 

- Vitamin C / Thiamine 

- Vasopressin vs. adrenaline vs. noradrenaline 

- Lots more 



Don't:

- Fixate on magic bullets 

- Target normoglycemia 

- Target hypothermia 

- Do too much - ventilation, transfusion, fluid resuscitation, oxygen, CRRT, HFO 

- Give synthetic colloid - especially HES 



Dr. Steve Mathieu - https://twitter.com/stevemathieu75



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