Hi everyone, this is Steve Carroll and this is the InBase podcast. Today's episode is a complete

revamp, a total redo on sepsis. I published the sepsis episode way back in February 2012,

and just a little bit has changed. And when I say a little bit, I mean a whole lot. Initially I was

intending to go back to the previous episode

and edit it for the changes, but there are just so many new things to talk about that I'm just

going to start from scratch. We not only have new sepsis definitions, but also new guidelines

from the surviving sepsis campaign that just came out about a month ago, and we'll be talking

about both in this episode.

First, let me say this. While the new sepsis definitions have been around for over a year,

I don't think we should totally throw out the old sepsis definitions for the purposes of medical education.

The new sepsis definitions, including the Q-Sofa criteria, assume that you have a baseline understanding

of how to recognize sepsis in your patients. I believe that the older definitions provided a good

framework about how to recognize severe sepsis and septic shock. However, if I start going through

those definitions now, alongside the new definitions, it'll just confuse the issue.

So here's what I'm going to do. Post it along with this episode is a separate shorter episode

that reviews just the old sepsis definitions. Basically, I took the old episode and cut out the part

where we talk about sepsis definitions. If you want, take a few minutes and listen to that episode,

because I think it will give you a good framework about how to recognize sepsis using the older definitions. Before we talk

about the new definitions, let's talk about what could lead you to suspect sepsis in the first

place from the history and physical exam. Unfortunately, there is no one specific history or

physical exam finding that will cause

you to suspect sepsis because it's a syndrome with many possible causes. Recognition of

...