(BQ) Part 2 book Current practice guidelines in inpatient medicine 2018–2019 has contents: Vertebral osteomyelitis, prosthetic joint infections, outpatient parenteral antibiotic therapy, thrombotic thrombocytopenic purpura, acute kidney injury,... and other contents.
97 Infectious Diseases Neil Jorgensen Marina Morie SEPSIS AND SEPTIC SHOCK Initial Assessment Definitions (SCC 2016) a Sepsis: “Life-threatening organ dysfunction caused by dysregulated host response to infection” b Septic shock: “Subset of sepsis with circulatory and cellular/metabolic dysfunction associated with higher risk of mortality” Diagnosis of sepsis a SSC 2016, NICE 2016: No diagnostic test to define sepsis; clinical diagnosis; treat if suspected or at risk of having sepsis Sepsis-3 2016: Clinical Criteria for Sepsis: Infection Plus Two or More Points from SOFA Score (See Table 6-1) If Not in ICU, May Use qSOFA Score (Easier Than SOFA) Diagnosis of septic shock a Sepsis-3 2016: Despite adequate fluid resuscitation i Vasopressors required to maintain MAP ≥65 mmHg, AND ii Serum lactate >2 mmol/L b NICE 2016: Infection + fever/feeling unwell, likely source of infection + clinical indicators (behavior/circulation/respiration) + risk factors for sepsis1 → Stratify risk of severe illness2 Acute Medical Management Initial resuscitation a SCC 2016 i Give at least 30 mL/kg of IV crystalloid (LR, NS) within hours Risk factors for sepsis: Age ≥75 years or