Algorithme thérapeutique

JEMS septembre 2016
Protocole Clinique SEPSIS

Pre hospital sepsis screening & ED alerts in Orange County, Fla.
Christopher Hunter, MD ; Amanda Stone, MD ; George Ralls, MD

System Sepsis Alert Protocol

A- Criteria Alert
1. Suspected infection
2. Two of the following items
Temperature > 38°C or <36°C
Respiratory rate > 20 breaths/min.
Heart Rate > 90 beats/min
3. ETCO2 < – 25 mmHg

B- Basis Life Support
100% O2

C- Advanced Life Support
1. ALS Assessment
2. Notify hospital of incoming Sepsis Alert
3. IV 0.9 NaCl
250 ml boluses until systolic pressure BP>90 mmHg
Total amount should not exceed 2 000ml
4. If systolic BP remains <90 mmHg after 1000 ml : dopamine infusion at 5-20 mcg/kg/min

Algorithme de prise en charge d’une anaphylaxie en service d’urgence