Know Your Guidelines – Sepsis Resuscitation Fluids?

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Guideline Knowledge Check, Medical News

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Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

Based on 2018 Surviving Sepsis Campaign (SSC) Guidelines…

Has the preferred IV resuscitation fluid for a patient with sepsis changed since the 2016 guidelines?

Yes or No?

Try this review question and find out if you're following the most current guideline.

Guideline Review Question

An 88-year-old man presents with a significant change in mental status. Urinalysis is positive for leukocyte esterase and is packed with bacteria and white blood cells. He is febrile and tachycardic. His systolic blood pressure is in the high 80s.

According to the 2018 Surviving Sepsis Campaign bundle (International Guidelines for Management of Sepsis and Septic Shock), which of the following principles should guide fluid resuscitation?

Answer Options:

Give up to 3 small hypertonic fluid boluses during initial resuscitation of patients with sepsis complicated by significant hypotension.

Titrate fluid replacement to clinical parameters during the hypotensive as well as post-resuscitation period.

Add colloids to the resuscitation fluid and give conservative crystalloid amounts according to clinical parameters to decrease the risk of pulmonary edema.

Lactated Ringer’s and normal saline are both equally acceptable crystalloid resuscitation fluids for treating a patient with sepsis.

Answer Explanation & References:

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About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.

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