ABSTRACT
Septic shock is a disease process characterized by a persistent, hyperdynamic, hypermetabolic state progressing to a gradual functional deterioration of multiple organs.1 Shock in general is a syndrome of generalized metabolic failure resulting from inadequate tissue perfusion; in septic shock, inadequate perfusion results from sepsis, bacteremia, or endotoxins. An estimated 400,000 cases occur each year worldwide with 100,000 cases treated in the United States anually.1 Septic shock is associated with an extremely high mortality: 30% in uncomplicated cases and over 80% in cases associated with multiple organ dysfunction syndrome.1,2
SEPSIS, SIRS, SEPTIC SHOCK It is often the case that the prehospital provider does not know whether septic shock, sepsis, or bacteremia is present until after definitive laboratory studies are performed. Since prompt recognition is always necessary to maximize survival, prehospital providers should be well-versed in the nomenclature pertaining to sepsis and related disorders. In an effort to mitigate the confusion regarding sepsis and associated syndromes, the Society of Critical Care Medicine Consensus Conference Committee and the American College of Chest Physicians revised the clinical categorization of sepsis to include SIRS, sepsis, and the varying degrees of septic shock.2 The revised definitions are explained in Figure 19-1.
