Doctor's Notes on Septic Shock
Septic shock has an official definition. It is persistent hypotension that results from an infection, requires vasopressors to elevate the blood pressure to maintain a mean arterial pressure of 65 mm/Hg or higher, and a serum lactate level >2 mmol/L despite adequate volume resuscitation. Signs and symptoms of septic shock may include of one or more of the following:
- Low blood pressure
- Rapid heart rate
- Low or high temperature
- Shortness of breath
- Little to no urine output
- Anxiety and/or agitation
- Pale or cool arms and legs
The major causes of septic shock are infection of the blood by gram-positive and gram-negative bacteria (other organs may also be infected). Risk factors include chronic diseases, genetic diseases immune system problems and being elderly or very young. Septic shock is a medical emergency. Treatment is with antibiotics, resolving hypotension with drugs and fluids and if needed, and resuscitation to support cardiac and respiratory function. Rapid treatment is necessary to avoid complications such as heart failure, abnormal blood clotting, respiratory failure, kidney failure, and death.
What Are the Treatments for Septic Shock?
For this emergency, have someone call 911, and immediately do the following:
- Begin CPR if patient not breathing, moving, coughing
- If possible, elevate feet about 12 inches.
- Keep patient still, try not to move the person.
- Loosen any restrictive clothing or other items like belts or watches.
- Cover with a blanket to prevent chilling.
- Turn vomiting or mouth bleeding patient onto their side.
- Treat with broad-spectrum antibiotics as soon as possible IV fluids as soon as possible.
- Vasopressors for low blood pressure
- Oxygen as needed
- Get patient to an ER, preferably by EMS transport
Consider treating any underlying causes, if possible; for example, surgical removal of infection such as abscesses or infected tissue, or gangrene.
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Just about any painful sore throat is caused by strep.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.