We were always told that Don’t underestimate triage or field vital signs! Now, we have a study that shows 25 % of patients presenting to ED with sepsis will progress to septic shock within 3 days.
This is a retrospective study with 3,960 patients that had two or more SIRS criteria. Approximately 12% of septic emergency department patients develop shock within 48 hours of presentation, and more than half of these patients develop shock after the first 4 hours of emergency department arrival. Factors associated with this turnout are: 1. Female Patients 2. non-persistent hypotension 3. Bandemia (10% at least) 4. Lactate of 4 5. PMH of CAD.
This tells me as always how important is to send these patient to ICU instead of IMC or floor and downgrade them from ICU instead of upgrade them to ICU!