SCREENING & EARLY TREATMENT
During resuscitation from sepsis-induced hypoperfusion, what type and volume of IV fluid is suggested?
Crystalloid and at least 30 ml/kg
When should IV antimicrobials be initiated in adults with possible septic shock or a high likelihood of sepsis?
Immediately, ideally within 1 hour
Do the 2021 SSC Guidelines suggest using IVIG to treat sepsis or septic shock?
No
What fluid is first-line for resuscitation in adults with sepsis or septic shock: crystalloids or colloids?
Crystalloids
What is the first-line vasopressor for septic shock?
Norepinephrine
What is the recommended initial target mean arterial pressure in patients with septic shock requiring vasopressors?
65 mm Hg
How many empiric antimicrobials with gram-negative coverage are suggested for adults with sepsis or septic shock and high risk for MDR organisms?
Two
Do the 2021 SSC Guidelines suggest using IV vitamin C to treat sepsis or septic shock?
No
What type of crystalloid fluid does SSC 2021 suggest using?
Balanced crystalloids
Does SSC 2021 suggest starting vasopressors peripherally, or waiting until central venous access is secured?
Starting vasopressors peripherally to restore MAP
What tool is NOT recommended to be used as a sole screening tool for sepsis and septic shock?
qSOFA
If a patient with sepsis or septic shock has a history of recent IV antibiotics, recurrent skin infections or chronic wounds, presence of invasive devices, or hemodialysis, what empiric therapy is recommended?
Antimicrobials with MRSA coverage
When does SSC 2021 suggest using corticosteroids?
When septic shock patients have ongoing requirements for vasopressor therapy
When does SSC 2021 suggest using albumin?
When patients receive large volumes of crystalloids
For adults with septic shock on the first-line vasopressor with inadequate MAP levels, what second-line agent should be added next?
Vasopressin
If elevated, this laboratory value is suggested to guide resuscitation for adults with sepsis or septic shock.
Lactate
If a patient with sepsis or septic shock has a history of neutropenia, stem cell transplantation, long ICU stay, CVCs, IVDU, TPN, or high dose corticosteroid therapy, what empiric therapy is suggested?
Antifungal therapy
What does SSC 2021 suggest regarding NMBA administration for adults with sepsis induced moderate-severe ARDS?
Intermittent NMBA bolus rather than continuous infusion
During initial resuscitation from sepsis-induced hypoperfusion, IV fluid should be given within what time frame?
1 hour (SSC 2018 Bundle)
3 hours (SSC 2021 Guidelines)
For adults with septic shock on the first- and second-line vasopressors with inadequate MAP levels, what agent does SSC 2021 suggest adding next?
Epinephrine
What tool is suggested to be used to guide resuscitation as an adjunct to other measures of perfusion in adults with septic shock?
Capillary refill time
What is the suggested duration of antimicrobial therapy for patients with adequate source control?
Shorter rather than longer therapy
When does SSC 2021 suggest using sodium bicarbonate therapy?
When adults with septic shock have severe metabolic acidemia and AKI
What assessment strategy does SSC 2021 suggest to guide fluid resuscitation?
Dynamic measures, rather than physical examination or static parameters alone
What does SSC 2021 suggest doing for adults with septic shock and cardiac dysfunction with persistent hypoperfusion despite adequate volume status and arterial blood pressure?
Either add dobutamine to norepinephrine, or use epinephrine alone