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Scand J Trauma Resusc Emerg Med. 2012 Jun 27;20:41. doi: 10.1186/1757-7241-20-41.

Initial emergency department diagnosis and management of adult patients with severe sepsis and septic shock.

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Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, USA.


Severe sepsis is a medical emergency affecting up to 18 million individuals world wide, with an annual incidence of 750,000 in North America alone. Mortality ranges between 28-50% of those individuals stricken by severe sepsis. Sepsis is a time critical illness, requiring early identification and prompt intervention in order to improve outcomes. This observation has led to increased awareness and education in the field of Emergency Medicine; it has also led to the implementation of critical interventions early in the course of patient management, specifically Early-Goal Directed Therapy, and rapid administration of appropriate antimicrobials. This review begins with a brief summary of the pathophysiology of sepsis, and then addresses the fundamental clinical aspects of ED identification and resuscitation of the septic patient.

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