TREATING SEPSIS

Step I – Iatrogenic injuries and complications

Critically ill patients are vulnerable: hiding within the intensive care unit is a variety of different injurious ambushes. Avoidance of hospital acquired injuries such as deep venous thrombosis (DVT), line sepsis, pressure sores is essential. In addition, the presence of an endotracheal tube provides a route for bowel organisms to infect the lungs. Prolonged use of neuromuscular blocking agents and steroids predispose to critical illness polymyopathy. Every intervention has a possible complication: the insertion of a central line can cause pneumothorax, air embolism, venous thrombosis, arterial dissection etc. You must weigh up the potential benefits and costs of each intervention.

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