Surviving Sepsis Guidelines 2021 Flashcards
True or false
We recommend AGAINST USING qSOFA compared with SIRS, NEWS, or MEWS as a single-screening tool quality evidence
for sepsis or septic shock.
True 
For adults suspected of having sepsis, we suggest measuring _______________
blood lactate
True or false
Sepsis and septic shock are medical emergencies, and we recommend that treatment and resuscitation begin immediately.
 True
For patients with sepsis induced hypoperfusion or
septic shock we suggest WHAT HYDRATION?
that AT LEAST 30 mL/kg of IV
crystalloid fluid should be given WITHIN THE FIRST 3 hr of resuscitation.
True or false
For adults with sepsis or septic shock, we suggest using DYNAMIC MEASURES to guide fluid resuscitation, over physical examination, or static parameters alone
 True
True or false
For adults with sepsis or septic shock, we suggest guiding resuscitation to DECREASE serum lactate in patients with elevated lactate level, over not using serum lactate.
 True
For adults with septic shock on vasopressors, we recommend an initial target mean arterial pressure (MAP) of __________ mm Hg over higher MAP targets.
65
True or false
For adults with sepsis or septic shock who require ICU admission, we suggest admitting the patients to the ICU within 6 hr.
True
True or false
For adults with suspected sepsis or septic shock but unconfirmed infection, we recommend continuously re-evaluating and searching for alternative diagnoses and discontinuing empiric antimicrobials if an alternative cause of illness is demonstrated or strongly suspected.
 True
Best practice statement
True or false
For adults with a low likelihood of infection and without shock, we suggest deferring antimicrobials while continuing to closely monitor the patient.
 True
True or false
For adults with possible sepsis without shock, we suggest a time-limited course of rapid investigation and if concern for infection persists, the administration of antimicrobials within 3 hr from the time when sepsis was first recognized.
 True
True or false
For adults with possible septic shock or a high likelihood for sepsis, we recommend administering antimicrobials immediately, ideally within 1 hr of recognition.
 True
True or false
For adults with suspected sepsis or septic shock, we suggest AGAINST using procalcitonin plus clinical evaluation to decide when to start antimicrobials, as compared to clinical evaluation alone.
 True 
True or false
For adults with sepsis or septic shock at low risk of MRSA, we suggest against using empiric antimicrobials with MRSA coverage, as compared with using antimicrobials without MRSA coverage.
 True
LOW OF HIGH, USE MRSACOVERAGE
 True or false
For adults with sepsis or septic shock, we recommend rapidly identifying or excluding a specific anatomical diagnosis of infection that requires emergent source control and implementing any required source control intervention as soon as medically and logistically practical.
 True 
True or false
For adults with sepsis or septic shock and HIGH risk
for multidrug resistant (MDR) organisms, we suggest
using TWO antimicrobials with gram-NEGATIVE coverage for empiric treatment over one gram-negative agent.
 True
True or false
For adults with sepsis or septic shock and LOW risk for multidrug resistant (MDR) organisms, we suggest AGAINST using two gram-negative agents for empiric treatment, as compared to one gram-negative agent.
 True
For adults with sepsis or septic shock, we suggest AGAINST using double gram-negative coverage ONCE the causative PATHOGEN and the susceptibilities are KNOWN
True
True or false
For adults with sepsis or septic shock, we suggest daily assessment for de-escalation of antimicrobials over using fixed durations of therapy without daily reassessment for de-escalation.
 True
True or false
For adults with an initial diagnosis of sepsis or septic shock and adequate source control, we suggest using shorter over longer duration of antimicrobial therapy.
 True
True or false
For adults with an initial diagnosis of sepsis or septic shock and adequate source control where optimal duration of therapy is unclear, we suggest using procalcitonin AND clinical evaluation to decide when to discontinue antimicrobials over clinical evaluation alone.
 True
YES to ALBUMIN
True
NO to STARCH and GELATIN
True
1st Norepinephrine
Inadequate MAP:
2nd Vasopressin
3rd Epinephrine
NO Terlipressin
True
True or false
For adults with septic shock and cardiac dysfunction with persistent hypoperfusion despite adequate volume status and arterial blood pressure, we suggest either adding
norepinephrine plus dobutamine
or
using epinephrine alone.
 True
Not to give septic shock and cardiac dysfunction with persistent hypoperfusion despite adequate volume status and arterial blood pressure
levosimendan
True or false
For adults with septic shock, we suggest starting
vasopressors peripherally to restore mean arterial Weak , very low pressure rather than delaying initiation until a central venous access is secured.
True 
True or false
For adults with sepsis-induced hypoxemic respiratory failure, we suggest the use of high flow nasal oxygen over noninvasive ventilation.
True 
