Surviving Sepsis Guidelines 2021

Question 1

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.

Answer 1

True 

Question 2

For adults suspected of having sepsis, we suggest measuring _______________

Answer 2

blood lactate

Question 3

True or false

Sepsis and septic shock are medical emergencies, and we recommend that treatment and resuscitation begin immediately.

Answer 3

 True

Question 4

For patients with sepsis induced hypoperfusion or
septic shock we suggest WHAT HYDRATION?

Answer 4

that AT LEAST 30 mL/kg of IV
crystalloid fluid should be given WITHIN THE FIRST 3 hr of resuscitation.

Question 5

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

Answer 5

 True

Question 6

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.

Answer 6

 True

Question 7

For adults with septic shock on vasopressors, we recommend an initial target mean arterial pressure (MAP) of __________ mm Hg over higher MAP targets.

Answer 7

65

Question 8

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.

Answer 8

True

Question 9

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.

Answer 9

 True

Best practice statement

Question 10

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.

Answer 10

 True

Question 11

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.

Answer 11

 True

Question 12

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.

Answer 12

 True

Question 13

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.

Answer 13

 True 

Question 14

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.

Answer 14

 True

LOW OF HIGH, USE MRSACOVERAGE

Question 15

 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.

Answer 15

 True 

Question 16

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.

Answer 16

 True

Question 17

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.

Answer 17

 True

Question 18

For adults with sepsis or septic shock, we suggest AGAINST using double gram-negative coverage ONCE the causative PATHOGEN and the susceptibilities are KNOWN

Answer 18

True

Question 19

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.

Answer 19

 True

Question 20

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.

Answer 20

 True

Question 21

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.

Answer 21

 True

Question 22

YES to ALBUMIN

Answer 22

True

Question 23

NO to STARCH and GELATIN

Answer 23

True

Question 24

1st Norepinephrine
Inadequate MAP:
2nd Vasopressin
3rd Epinephrine

NO Terlipressin

Answer 24

True

Question 25

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.

Answer 25

 True

Question 26

Not to give septic shock and cardiac dysfunction with persistent hypoperfusion despite adequate volume status and arterial blood pressure

Answer 26

levosimendan

Question 27

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.

Answer 27

True 

Question 28

True or false

For adults with sepsis-induced hypoxemic respiratory failure, we suggest the use of high flow nasal oxygen over noninvasive ventilation.

Answer 28

True