This is EMKases, EM Quick Hits podcast.

Quick. Let's get on with it.

EM cases is part of Shremie, the Schwartz-Riseman Emergency Medicine Institute.

That's the nonprofit-profit organization dedicated

to improving EM care through high-quality research and education. The opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases.

First up, we have Britt Long, who's going to update us on the newest sepsis guidelines.

Now, there are a few things to be aware of since our 2019 episode on Sepsis and Septic Shock with Sarah Gray live from the EM cases course.

So take it away, Britt.

The surviving sepsis campaign just released their 2021 updates in December. I love managing sepsis, so I couldn't wait to take a look. For this quick hits episode, I'm going to break down

some of the key updates. Now, there's no way I can cover all

the 93 different recommendations, but I have picked some of the major ones that affect us in the

ED. First, we need to talk a bit about screening tools for sepsis. One of the more recent tools

is Q's SOFA. This includes a GCS of less than 15, rest rate of 22 or greater, and a systolic blood pressure

of 100 or less. If two of these are present, we need to think about sepsis and infection.

This seems user-friendly something that we can easily use at the bedside, but the evidence behind

its use is controversial. It has poor sensitivity, and the guidelines actually recommend

against using this as a single

screening tool.

However, they do suggest obtaining a lactate level in those with suspected sepsis, but using

this only as an adjunctive test.

Lactate alone should not be used to rule in or rule out sepsis.

My favorite screening tool for septic shock is news, national early warning score,

...