overriding principles of sepsis therapy, however, remain constant regardless of
age and focus on simultaneously restoring normal physiology via supportive
measures, while identifying and treating the source of sepsis itself. Most
importantly, supportive therapy is goal directed and time sensitive with ultimate
goal of providing and escalating therapy within the hour of suspicion of sepsis.
The latest guidelines incorporate evidence available through the fall of 2012 and
are discussed in following section.[ 7 ]^
Restoring Normal Physiology:
0 - 5 minutes: Have a high index of suspicion and recognize signs
of hypoperfusion and changes in mental status. Establish
vascular access and provide supplemental oxygen. Place either a
peripheral or intraosseous IV. Central access, if not already present,
can be established once resuscitation has already began, but attempts
for a central line should not delay initiation of fluids, antibiotics, and
other necessary intravenous therapies.
Supplemental O2 may be delivered via nasal cannula, high flow
cannula, or other means of non-invasive ventilation such as CPAP.