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Lessons in Transport - Surviving Sepsis
Prehospital Medicine Ryan Gerecht, MD Prehospital Medicine Ryan Gerecht, MD

Lessons in Transport - Surviving Sepsis

We routinely transport patients with severe sepsis and septic shock by both air and ground. Take a few moments to review these high yield management pearls from the 3rd edition of the Surviving Sepsis Campaign Guidelines.

Initial Resuscitation:

  • Goals during the first 6 hours of resuscitation:
  • CVP 8-12 mmHg (a debate on the utility of CVP or lack their of is beyond the scope of this LIT)
  • MAP >  65 mmHg
  • Urine output >  0.5ml/kg/hr
  • Central venous or mixed venous oxygen saturation 70% or 65% respectively (grade 1c)
  • In patients with elevated lacate levels we should target resuscitation to normalize lactate (grade 2c)
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Lessons in Transport - Post-Intubation Checklists
Prehospital Medicine, Lessons in Transport Medicine Ryan Gerecht, MD Prehospital Medicine, Lessons in Transport Medicine Ryan Gerecht, MD

Lessons in Transport - Post-Intubation Checklists

Post-Intubation Checklists

Making a checklist can help cognitively unload you in high stakes and high pressure situations.  Post-intubation consider the following important points:

Protecting the Tube

  • Continuous wave form ETCO2... each and every time

  • Secure Endotracheal Tube at the appropriate depth (See LIT week 6)

  • Analgesia and Sedation

  • Restraints... Do you know where the soft restraints are stored?

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