Cite this post as:
Scott Weingart, MD FCCM. EMCrit Wee – Sean Townsend of the SSC and the ProCESS Trial. EMCrit Blog. Published on May 9, 2014. Accessed on April 23rd 2024. Available at [https://emcrit.org/emcrit/ssc-process-trial-response/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: May 9, 2014
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
You finished the 'cast,
Now Join EMCrit!
As a member, you can...
- Get CME hours
- Get the On Deeper Reflection Podcast
- Support the show
- Write it off on your taxes or get reimbursed by your department
.
Get the EMCrit Newsletter
If you enjoyed this post, you will almost certainly enjoy our others. Subscribe to our email list to keep informed on all of the Resuscitation and Critical Care goodness.
This Post was by the EMCrit Crew, published 10 years ago. We never spam; we hate spammers! Spammers probably work for the Joint Commission.
Your thoughts:
Patient with SIRS who is normotensive and has a normal lactate. If the labs come back later with criteria for severe sepsis (ie worsening creatinine, bilirubin, low platelets), do you still give this patient 30cc/kg of fluids. Once again the patient has a normal MAP and a normal lactate????
don’t yet buy those as criteria for severe sepsis
Dr Weingart
Thank you for your dedication to keep the podcast going even when you still have the cold. Your passion is not wavering.
thanks, bud!
hi scott.
check this one out. it specifically addressed sepsis induced hypotension +/- hyperlactatemia.
http://www.ncbi.nlm.nih.gov/pubmed/21126850
lactate as a metabolic marker of severity of sepsis and trigger for/endpoint of resuscitation makes sense.
cheers.
Hi Scott Really fascinating interview! Clearly there is a bit of beard-stroking to be done by the folk who write the Surviving Sepsis guidelines. Will be interesting to see what happens once PROMISE and ARISE are out there. As you know – I am a small ED doc and I believe that the ProCESS does change my practice – or at least it means that I can feel more comfortable with my own local pragmatic protocol. At the end of the day the EGDT protocol is beyond the reach of the majority of non-academic EDs in Australia, and elsewhere. So… Read more »
thanks brother, I’ll do an expanded version of the SMACC talk in 2 weeks on EMCrit and will certainly link to your excellent post
Scott–thanks for this wee. It’s nice to be reminded that, though we may quibble with some of the specifics (and I do), these guidelines are put together by smart, thoughtful people that are also looking at the data.
that sums up my thoughts exactly!
Two comments from your podcast were interesting: Weingert (about 10:10): “…if you just initiate any protocol that involves caring about these patients you would probably achieve similar reductions in mortality.” Townsend (about 10:45): “…I believe that protocolized care…will lower mortality versus just doing whatever happens next in the hospital in a random sort of fashion.” We have very few protocols my current ICU. I told one of the attendings recently we would provide better care if we would just create some protocols that standardized care, even if there was no evidence supporting the choice. For example it is pretty clear… Read more »
I have to thank you for providing such a great collection of knowledge and evidence based practice regarding sepsis. Over the past few years I’ve seen sepsis management work really well, such as the Code SMART at Newark Beth Israel Medical Center http://www.hindawi.com/journals/ccrp/2012/980369/ and sepsis management that hasn’t quite gotten off the ground for reasons that I cannot explain nor quite understand. As an ED nurse I value the Severe Sepsis Triage Screening Tool that was part of the New York City Severe Sepsis Project you posted a while back. I feel it is an easy way to get the… Read more »