Sepsis continues to affect 1.5 million people and lead to 250,000 deaths in the U.S., according to the CDC.  The CORTICUS study reviewed here (article below)  is the landmark study evaluating the potential benefit of corticosteroids in septic patients.

As a reminder, the standard of care for sepsis includes:

• Prompt recognition and treatment
• Within 3 hours of declaring sepsis:
  • Obtain blood cultures and lactate
  • Administer antibiotics before obtaining blood cultures
  • Resuscitate with at least 30cc/kg crystalloid IV fluids
• Within 6 hours:
  • Re-check lactate if initially >2
  • If there is persistent hypotension after initial fluid administration (MAP < 65 mm Hg) or if initial lactate was ≥4, re-assess volume status and tissue perfusion*
  • Administer more IV fluids or vasopressors if needed to maintain MAP ≥65

And remember to document your evaluation, diagnosis and plan, particularly if your plan deviates from recommended guidelines.

*Document the following:
Vitals & Exam: vitals, lung, heart, peripheral pulse, capillary refill, skin
or Diagnostics: measure CVP, measure ScvO2, echocardiogram, dynamic assessment of fluid responsiveness with passive leg raise or fluid challenge