Sepsis与感染性休克的急诊救治及流程优化

Sepsis and Septic Shock in Emergency Department: Management and Process Optimization

Sepsis及感染性休克是临床常见的综合症,与患者预后密切相关。早期救治对Sepsis及感染性休克至关重要。急诊医师在早期诊断Sepsis、评价危险因素和早期复苏方面均起到至关重要的作用。目前证据表明,"Sepsis的集束化治疗"能够改善此类患者预后,2018年4月"拯救Sepsis运动"再次更新了相关推荐意见,提出了"1 h集束化治疗目标",这对急诊医师提出了更高的要求。本文拟从救治流程、具体处理及可能的政策指导方面讨论Sepsis及感染性休克的急诊优化治疗,以期提高指南依从性和治疗质量,由此改善此类患者的预后。

Sepsis and septic shock continue to be a devastating syndrome that is associated with morbidity and mortality. Sepsis and septic shock are time-critical conditions. Emergency department（ ED） plays a vital role in the identification,risk stratification,and resuscitation for patients with sepsis or septic shock. The＂sepsis bundle＂has been reported to improve the outcome of sepsis. In April 2018,the Surviving Sepsis Campaign issued an ＂ hour-1 bundle＂for patients with suspected sepsis. Getting this ＂ hour-1 bundle＂done in less than 1 hour will be a challenge for emergency physicians. The aim of this review was to discuss the process,management,and possible future policies to improve the compliance to the bundle and quality metrics so that encourage a rapid and high-quality care of sepsis and septic shock in the ED.