Hi and welcome back of the Month.

We're going to be running through a few papers

and it probably won't come as a massive surprise

that we're going to be covering sepsis,

we're also going to be talking about sedation,

and finally we'll wrap up with acute coronary syndrome in the elderly

population and how aggressive we should be or invasive with our treatment strategy.

So first of all let's start off with sepsis and the paper that's just been published

in JAMA. Now there are some fantastic foam resources out there already that cover this subject.

I think Foamcast were the first to get a great podcast out about the definitions and the new

categories for sepsis. There's a good blog over at St Emlens for what it's worth here's our take on it.

So as you all know we've been using SERS plus a suspected infection as the definition of

sepsis for the last well several years certainly more than 10.

We've then been stepping up sepsis into sepsis, severe sepsis and septic shock, depending on organ hypopofusion or hypotension,

which was refractory to fluid resuscitation. In each of those categories, we were getting used to

assigning a different degree of mortality. We've been looking at papers over the last few years,

a rise, promise and process, which

has looked at the comparison between early goal directed therapy, which was Manny Rivers'

original work, compared to now normal standard therapy.

And just when we were getting comfortable with sepsis and our new management of it, along

comes a new set of definitions on how we should actually

categorise sepsis.

...