Perfusion Measurement of the Septic Patient in the Emergency Department

Abstract

Sepsis is a deadly disease, more complex and frequent every day, that requires management from different specialists. The emergency physician is the first and one of the most important physicians that has to deal with the septic critically ill patients, because an appropriate initial management is key to a favorable outcome.In the emergency department it can be hard to predict which patients will become sicker just with information from the vital signs, and it's even harder to predict which patients will require a more intensive medical treatment. That is the reason why there must be more resources to measure tissue perfusion in an early and simple way in the emergency room, so that the emergency physician can manage to establish which patients requires earlier intervention to improve their perfusion state, despite not showing any clinically evident signs that help in the diagnosis of their current state.The goal of this paper is to propose a diagnostic and therapeutic algorithm for the hypoperfused patient with septic shock in the emergency department.venous oxygen saturation, arterial and venous lactate, microcirculatory study in different anatomical sites and oxygenation indexes.The emergency department, a place of rapid transit, with time constraints, progressive overcrowding and limited physical space, requires efficient indicators of early appearance and simple implementation in the system. That is why this article aims to show a proposal of early detection of hypoperfusion in the septic patient in the emergency room.

The Incredible Breadth of Emergency Medicine

“…Taking just two of the manuscripts in this issue, sepsis and traumatic brain injury, one quickly realizes that emergency medicine is in the center and on the front lines of the biggest topics and challenges in medicine. We are forced to develop "diagnostic and therapeutic algorithm for the hypoperfused patient with septic shock in the emergency department" and do not simply borrow from other specialists who treat such patients [5]. Many patients with hyperkalemia are saved or lost in the emergency department and we study "Predictors of Outcome in Patients Presenting with Moderate to Severe Hyperkalemia" [6].…”