Management of the patient with sepsis in emergency department: a new alternative protocol

Sepsis is a clinical syndrome induced from the host response to an infection. Severe sepsis is the leading cause of death in critically ill patients. The introduction of the early goaldirected therapy (EGDT) has been able to reduce mortality in patients with severe sepsis/ septic shock. However, sepsis mortality rates remain high compared to other critical illnesses. Many studies have pointed out that the use of arterial line placement and the execution of central venous pressure and central venous oxygen saturation measurements are the most difficult EGDT elements to carry out in community hospitals. For these reasons, the present independent review examines recent pathogenic, diagnostic, and therapeutic development in sepsis with particular relevance to the emergency practice, following the latest guidelines published in February 2013 and several recent studies. We propose a non-invasive alternative protocol which can replace the standard treatment with non-substantial changes in the patient outcome though overcoming the obstacles of a invasive method.