The Curbsiders Internal Medicine Podcast #419 Rapid Response Series: Sepsis with Dr. Mohleen Kang A shock to the system
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Dec 4, 2023 Guest Dr. Mohleen Kang from Emory University joins the hosts to discuss sepsis recognition, initial management, sepsis scoring systems, diagnostic work-up, antibiotic management, fluids, pressors, and supportive measures for sepsis patients. They emphasize the importance of gathering patient information, evolving sepsis definitions, clinical diagnosis and imaging, antibiotic selection, prioritizing antibiotics for skin infections, management of sepsis, and identification and treatment of sepsis.
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Ask The Patient And Nurse First
- Talk to the patient and bedside nurse first to find a localizing complaint before doing interventions.
- Use focused questions to identify surgical site, respiratory, or urinary sources quickly.
Control The Crowd And Assign Roles
- Assign roles and limit the rapid response team to essential members: ICU nurse, 1–2 bedside nurses, charge nurse, respiratory therapist, and the patient's nurse.
- Ask nonessential staff to step outside so you can communicate clearly and act quickly.
Scoring Systems Trade Sensitivity For Specificity
- SIRS criteria are nonspecific and will flag many hospitalized patients.
- qSOFA is specific but insensitive; NEWS/MEWS perform better for hospital dashboards.