Improving Recognition of Abnormal Vital Signs: A Key Area of Intervention for Earlier Sepsis Diagnosis and Management

2020 ◽  
Vol 21 (3) ◽  
pp. B22
Author(s):  
Zaib Khan ◽  
Zaib Khan ◽  
Shivani Chopra ◽  
Katerina Oikonomou ◽  
Daniel Gaballa ◽  
...  
Keyword(s):  
Vital Signs ◽  
Diagnosis And Management ◽  
Sepsis Diagnosis

scholarly journals How Can the Microbiologist Help in Diagnosing Neonatal Sepsis?

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Michela Paolucci ◽  
Maria Paola Landini ◽  
Vittorio Sambri
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Gold Standard ◽  
Early Onset ◽  
Late Onset ◽  
Molecular Techniques ◽  
Diagnosis And Treatment ◽  
Diagnosis And Management ◽  
Sepsis Diagnosis ◽  
Expected Outcomes

Neonatal sepsis can be classified into two subtypes depending upon whether the onset of symptoms is before 72 hours of life (early-onset neonatal sepsis—EONS) or later (late-onset neonatal sepsis—LONS). These definitions have contributed greatly to diagnosis and treatment by identifying which microorganisms are likely to be responsible for sepsis during these periods and the expected outcomes of infection. This paper focuses on the tools that microbiologist can offer to diagnose and eventually prevent neonatal sepsis. Here, we discuss the advantages and limitation of the blood culture, the actual gold standard for sepsis diagnosis. In addition, we examine the utility of molecular techniques in the diagnosis and management of neonatal sepsis.

scholarly journals Diagnosis and Management of Non-Purulent Cellulitis in the Emergency Department

CJEM ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 186-189
Author(s):  
Krishan Yadav ◽  
Hans Rosenberg ◽  
Debra Eagles ◽  
Kathryn N. Suh
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Lower Extremity ◽  
Vital Signs ◽  
Small Degree ◽  
Clinical Findings ◽  
Diagnosis And Management ◽  
Medication Noncompliance ◽  
History Of

A 47-year-old homeless male presents to the emergency department (ED) with right lower extremity swelling, erythema and pain. He has diabetes mellitus, and had one prior episode of cellulitis three months ago affecting the same leg. He has a history of medication noncompliance. At triage, his temperature is 38.3°C but the remaining vital signs are unremarkable. On examination of the affected leg, there is an approximately 10 × 10 cm area of erythema, induration and increased warmth. There is mild tenderness to palpation and you wonder if there is a small degree of fluctuance. There is no lymphangitis, crepitus, necrosis or pain out of proportion to clinical findings.

scholarly journals Prognostic value of diagnostic scales in community-acquired sepsis mortality at an emergency service. Prognosis in community-adquired sepsis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jorge Clar ◽  
María Rosa Oltra ◽  
Raquel Benavent ◽  
Carolina Pinto ◽  
Adrian Ruiz ◽  
...  
Keyword(s):  
Emergency Room ◽  
Prognostic Value ◽  
Vital Signs ◽  
Roc Curves ◽  
Added Value ◽  
University Hospital ◽  
Predictive Capacity ◽  
Sepsis Diagnosis ◽  
High Flow Oxygen ◽  
Time Of Admission

Abstract Objectives To asses the prognostic value of diagnostic scales in mortality of community-adquired sepsis and added value of additional parameters. Methods Prospective observational study of patients with community-adquired sepsis in the Emergency Room of University Hospital. The study population were patients presented in the Emergency Room with confirmed infection and practicians sepsis diagnosis. Demographics, triage vital signs, inhaled oxygen fraction, inflammatory markers, biochemistry, all-cause mortality during hospitalization and three months after were recorded. Prognostic value of qSOFA, NEWS, SOFA, SIRS, and amplified scales were calculated by using logistic regression and ROC curves. Results 201 patients, 54% male, average age 77±11,2 years were included. Sixty-three (31.5%) died during hospitalization and 24 (12%) three months after discharge. At the time of admission vital signs related with in-hospital mortality were Glasgow Coma Scale <13, respiratory rate ≥22 bpm, temperature, oxygen desaturation, high flow oxygen therapy and heart rate. Patients dead in-hospital had lower PaCO2, higher lactate, glucose and creatinine. Greater predictive capacity of the scales, from higher to lower, was: qSOFA, NEWS2, SOFA and SIRS. Amplified scales with lactate >2mg/dl, glucose, blood level >190mg/dl and PaCO2 <35mmHg improved predictive value. Conclusion Amplified-qSOFA and amplified-NEWS2 scales at Emergency Department may offer a better prognostic of septic patients mortality.

scholarly journals 48-year-old with Altered Mental Status and Respiratory Failure: A Case Report

2021 ◽  
Vol 5 (4) ◽  
pp. 502-506
Author(s):  
Justin Pile ◽  
Justina Truong
Keyword(s):  
Respiratory Failure ◽  
Physical Examination ◽  
Mental Status ◽  
Vital Signs ◽  
Altered Mental Status ◽  
Diagnostic Tools ◽  
Diagnosis And Management ◽  
Breath Sounds ◽  
Mortality Case ◽  
Iv Drug Use

Introduction: The differential diagnosis for altered mental status and respiratory failure is broad. Careful physical examination, appropriate use of diagnostic tools, and accurate interpretation and correlation of test results are important for piecing together the puzzle of a patient with altered mental status that emergency physicians commonly face. In certain cases, such as this one, rapid diagnosis and management is crucial for improving patient morbidity and mortality. Case Presentation: A 48-year-old male with altered mental status and respiratory failure presented to the emergency department after being found unconscious on his porch. Vital signs were notable for temperature 105.5 °F, blood pressure 202/102 millimeters of mercury, pulse 126 beats per minute, respiratory rate 30 breaths per minute, and oxygen saturation 91% on room air. Physical examination revealed an obese male lying in bed awake in severe distress with labored breathing and unable to converse. His physical examination was significant for dry mucous membranes, tachycardia, and bilateral lower extremity 1+ pitting edema. He also appeared to have Kussmaul respirations with severe tachypnea, but his breath sounds were clear to auscultation bilaterally. On further examination, the patient appeared to have intravenous (IV) injection markings along his arms suggesting the possibility of IV drug use. Discussion: With limited history, the only context clues initially available to assist in the diagnosis were abnormal vital signs and physical examination. The patient was tachycardic, hyperthermic, hypertensive, hypoxic, and tachypneic with altered mental status; he eventually required endotracheal intubation for hypoxic respiratory failure. The complexity of his condition prompted a large list for the differential diagnoses. Toxidromes, endocrine abnormalities, infectious process, cardiac and/or renal etiologies, and neurological pathology such as a cerebrovascular accident were considered. In the case of this patient, urgent diagnosis and management was crucial to prevent further decompensation and improve his outcome.

scholarly journals Knowledge assessment of Sepsis Diagnosis and Management during COVID-19 pandemic among House Officers & Medical Officers in Ibrahim Malik Teaching Hospital in Khartoum State, Sudan, 2021

2021 ◽  
Author(s):  
ElMuiz Abdelrahman ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Ibrahim Mahgoub ◽  
Mohammed Eltahier Abdalla Omer ◽  
Yassin Abdelrahim Abdalla ◽  
...  
Keyword(s):  
Medical Knowledge ◽  
Knowledge Score ◽  
P Value ◽  
Sepsis Management ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Sepsis Diagnosis ◽  
Significant Difference ◽  
Life Threatening ◽  
The Mean

Abstract Background: Sepsis is life-threatening and frequently a final common pathway to death for many infectious diseases worldwide and may lead to death if left untreated. The objective is to assess the scientific medical knowledge upon sepsis among House officers and Medical officers in terms of diagnosis and management.Method: An observational cross sectional Hospital-based study was conducted through self-administered retrospective questionnaires based on the objective of the study. We enrolled 155 participants through Convenience sampling. The questionnaire contains parts of validated Sepsis criteria in terms of diagnosis and management. Analysis was done by using SPSS version 20. Data are presenter as frequencies and percentages using figures and tables. P value less than 0.05 considered significant Mann Whitney U test use to compare level of knowledge adherence between trained participants and non-trained participants.Results: The mean knowledge score about sepsis diagnosis was 2.6 out of 10 (SD= 1.8), and about sepsis management was 2.8 out of 8 (SD=1.8) the mean overall score was 5.5 out of 18.No significant difference found between participants who were trained upon diagnosis and management of sepsis and those who were not.Conclusion: Study findings illustrated that the capacity to perceive and manage sepsis among House Officers and Medical Officers doctors is poor and there are dangerous gaps in their investigation and management of such septic patients.

scholarly journals Advances in sepsis diagnosis and management: a paradigm shift towards nanotechnology

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Amit Pant ◽  
Irene Mackraj ◽  
Thirumala Govender
Keyword(s):  
Critical Role ◽  
Sepsis Management ◽  
Diagnosis And Management ◽  
Resistance Surface ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Extracorporeal Blood Purification ◽  
Highly Sensitive ◽  
Life Threatening

AbstractSepsis, a dysregulated immune response due to life-threatening organ dysfunction, caused by drug-resistant pathogens, is a major global health threat contributing to high disease burden. Clinical outcomes in sepsis depend on timely diagnosis and appropriate early therapeutic intervention. There is a growing interest in the evaluation of nanotechnology-based solutions for sepsis management due to the inherent and unique properties of these nano-sized systems. This review presents recent advancements in nanotechnology-based solutions for sepsis diagnosis and management. Development of nanosensors based on electrochemical, immunological or magnetic principals provide highly sensitive, selective and rapid detection of sepsis biomarkers such as procalcitonin and C-reactive protein and are reviewed extensively. Nanoparticle-based drug delivery of antibiotics in sepsis models have shown promising results in combating drug resistance. Surface functionalization with antimicrobial peptides further enhances efficacy by targeting pathogens or specific microenvironments. Various strategies in nanoformulations have demonstrated the ability to deliver antibiotics and anti-inflammatory agents, simultaneously, have been reviewed. The critical role of nanoformulations of other adjuvant therapies including antioxidant, antitoxins and extracorporeal blood purification in sepsis management are also highlighted. Nanodiagnostics and nanotherapeutics in sepsis have enormous potential and provide new perspectives in sepsis management, supported by promising future biomedical applications included in the review.

Role of the allergist in diagnosis and management of patients with uveitis

JAMA ◽  
1966 ◽  
Vol 195 (3) ◽  
pp. 167-172 ◽  
Author(s):  
T. E. Van Metre
Keyword(s):  
Diagnosis And Management
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