SEPTIC SHOCK: 

S: Start Antibiotics - within first hour (collect cultures)

E: Enteral Nutrition: (Early: helps with GI integrity)

P: - proteitn activated C: antithrombotic, inflammatory effects 

• (most effective if started within first 24- 48 hours)

T: Titrate vasopressors to keep MAP= Greater than 65 

EX) norepinephrine 

• Used when fluid replacement is unsuccessful 

• Causes vasoconstriction and increases SVR 

I: Inotropes: if there is low tissue perfusion

EX) dobutamine

• Helps increase the strength of the heart's contraction 

C: crystalloids or colloid solutions 

• Used as the first initial treatment… if not working then vasopressors are added to the treatment 

• Successful if increasing BP and CVP within normal ranges 8-12 mmHg

• Unsuccessful if persistent hypotension and CVPs less than 8mmHg

S: Steroids (corticosteroids: low dose)

• Used in some patients to help decrease the amplified inflammation by the immune system, especially if patient isnt responding to vasopressors 

H: Hemodynamic monitoring

• Treated in ICU 

• Will have central venous/ arterial cath to assess tissue perfusion & filling pressures in the heart 

EX) CVP filling pressures in the heart right side 

PAWP: filling pressure on right side of the heart 

 

O: Oxygenate 

• Keep o2sat over 95%

• At risk for ARDS 

C: Cultures

K: Keep glucose below 180>> prevent hyperglycemia 

• Started on insulin gtt to control 

• Monitor serum lactate levels: over 2-4mmol= cells are struggling for oxygen, switched to anaerobic metabolism 

• Monitor UOP (foley insertion): over 30 ml/hr… if low, kidneys are failing due to decreased tissue perfusion