Lies, Damned Lies, and Sepsis Bundles

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The Surviving Sepsis Campaign recently released an update to the bundles of care it recommends for “sepsis” patients. You may have heard of the three-hour bundle, which essentially means that you do a bunch of stuff (lactate, cultures, antibiotics, fluids) within three hours of the patient declaring himself as having severe sepsis. If you don’t do all the stuff—say, for example, the patient got antibiotics prior to blood cultures—you get an F even if you did everything else. The campaign made a dramatic change to how we define sepsis and how we risk-stratify patients in 2016. You undoubtedly have heard of the SOFA score or the qSOFA score and that our traditional SIRS criteria were unfortunately not sensitive enough (and have never been very specific) for sepsis, which they called Sepsis-3.

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