Sepsis in the emergency department: Key points, controversies, and proposals for improvements in Latin America

Agustín Julián-Jiménez, Mark Supino, Jesús Daniel López Tapia, Carolina Ulloa González, Luis Eduardo Vargas Téllez, Juan González Del Castillo, Alejandro Moyá Álvarez, Luis Loro Chero, Ulises González Bascuñán, Francisco Javier Candel González, Olinda Giselle Garza Sáenz, Fabián Andrés Rosas Romero, Luis Antonio Gorordo Delsol

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Although infection rates and the impact of infection on hospital emergency departments (EDs) are known or can be reliably estimated, the incidence and prevalence of sepsis vary in relation to which definitions or registers used. Sepsis is also well known to be under-diagnosed by physicians in general and by ED physicians in particular. Over half of sepsis cases are community-acquired, and 50% to 60% of patients in intensive care units (ICUs) with sepsis or septic shock are admitted directly from the ED. Pneumonia and urinary tract infections are the most common points of focus in sepsis, septic shock, bacteremia, and ED admissions to the ICU for infectious processes. For this article a multinational group of experts representing Latin American emergency medicine associations reviewed and analyzed similarities and differences in the epidemiology of sepsis in different geographic locations. We consider key aspects and geographic similarities and differences in the early identification of patients with severe sepsis; criteria that define the diagnosis; appropriate early antibiotic and fluid therapy; the roles of triage systems and multidisciplinary sepsis code units; and the use of biological markers in this time-dependent disease. We also discuss key points and strategies for improving the diagnosis, prognosis, and care of sepsis patients in the ED.

Original languageEnglish
Pages (from-to)123-135
Number of pages13
JournalEmergencias
Volume31
Issue number2
Publication statusPublished - 1 Apr 2019

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