CoROM cast. Wilderness, Austere, Remote and Resource-limited Medicine. 175-Sepsis Discussion from the JTS CPG
Dec 26, 2025
Join a riveting discussion on managing sepsis in remote care. The hosts dive into assessing septic patients with focused history and trending vitals. Learn about the importance of early warning systems like QSOFA and NEWS2. They explore the critical role of point-of-care ultrasound and monitoring techniques, including MAP and urine output. Antibiotic strategies in austere settings are highlighted, alongside malaria treatment protocols. The episode wraps up with innovative care methods like telemedicine consultations and the FLASH mnemonic for risk assessment.
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Sepsis Is A Spectrum To Anticipate
- Sepsis is a spectrum from infection to organ dysfunction to septic shock and requires early recognition.
- Bill Vasios emphasizes anticipating both the most likely and the worst outcomes to guide treatment.
Trend Vitals And Use Early Warning Scores
- Use early warning scores (qSOFA, NEWS2) and trend vital signs to detect deterioration early.
- Prioritize history, serial vitals, and clinical acumen over indiscriminate testing in remote settings.
Three Practical Resuscitation Targets
- Focus on three monitoring 'plates': maintain MAP >65, adequate urine output, and mental status.
- Use urine output and mentation as practical endpoints when lab access is limited.