From the Research
When assessing a patient for sepsis, a comprehensive review of systems should focus on identifying signs of infection and organ dysfunction, prioritizing questions that help identify the potential source of infection and assess for end-organ dysfunction, as delayed intervention significantly increases mortality risk 1.
Key Areas to Assess
- Respiratory symptoms: shortness of breath, cough, sputum production, and chest pain
- Cardiovascular assessment: palpitations, dizziness, syncope, and peripheral edema
- Gastrointestinal questions: abdominal pain, nausea, vomiting, diarrhea, and changes in bowel habits
- Genitourinary symptoms: dysuria, frequency, urgency, flank pain, and changes in urine output or color
- Neurological status: confusion, altered mental status, headache, and neck stiffness
- Skin-related questions: rashes, wounds, or areas of warmth, redness, or drainage
- Musculoskeletal pain: particularly joint pain that could indicate septic arthritis
Importance of Early Recognition
Early recognition of sepsis is critical, as delayed intervention significantly increases mortality risk 2, 3, 4. The use of automated monitoring systems may facilitate earlier recognition of sepsis, but the evidence is still limited and of low quality 2.
Systemic Symptoms
Systemic symptoms such as altered mental status, dyspnea, gastrointestinal symptoms, and muscle weakness can predict the presence or development of severe sepsis and septic shock 1.
Personalized Approach
A personalized approach to fluid resuscitation during sepsis is recommended, taking into account individual patient characteristics and response to treatment 5.