Podcast 89 – Lessons from the STOP Sepsis Collaborative - a podcast by Scott D. Weingart, MD FCCM

We have hit the 10,000 patient mark in the NYC STOP Sepsis collaborative. Here are some of the lessons learned...



Want to See the Protocols?

Recognition



* Let nurses handle recognition



Lactate



* Send lots of lactates

* Lactate turn-around 30 minutes or get Point-of-Care

* Run the lactates on a blood gas machine

* Make lactate >=4 a panic value



Treatment



* Prompt palliative vs. curative

* Non-invasive protocols have evidence and seem to be working



Want to See the Protocols?

Early appropriate antibiotics



* Empiric Abx Guidelines

* First dose of those antibiotics in the ED

* Simultaneous Infusions



Intubation



* Safe Intubation



Fluids



* Echo Assessment of Cardiac Output

* IVC ultrasound (Also check out the Stone Debate)

* If empiric fluid-loading, give 4-6 liters



Pressors



* Do a sterile neck line or a non-sterile femoral (which should be yanked and replaced as soon as the patient gets upstairs)

* Norepi should be your 1st pressor choice



Check Your Work



* Mandate repeat lactates



More Sepsis Resources



* Manny Rivers on Early Goal Directed Therapy

* A tirade on Sepsis Care in the ED (And additional follow-up) Back then there was no Non-Invasive Path

* That was until Alan Jones published his lactate clearance study

* Find a ton of evidence and other good stuff on the EMCrit Severe Sepsis Deep Dive Pages



 The Proposed NQF Measure

Read it and weep



Please contact the folks in your hospital that will be voting on the measure

On a Side Note...

EMCrit just broke the 3 Million Downloads mark. Yeah!!!!

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