Meier Brian, Staton Catherine
Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, DUMC Box 3096, 2301 Erwin Road, Duke North, Suite 2600, Durham, NC 27710, USA; Duke Global Health Institute, Trent Hall, 310 Trent Drive, Durham, NC 27710, USA.
Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, DUMC Box 3096, 2301 Erwin Road, Duke North, Suite 2600, Durham, NC 27710, USA; Duke Global Health Institute, Trent Hall, 310 Trent Drive, Durham, NC 27710, USA.
Emerg Med Clin North Am. 2017 Feb;35(1):159-173. doi: 10.1016/j.emc.2016.08.004.
Our evolving understanding of the physiologic processes that lead to sepsis has led to updated consensus guidelines outlining priorities in the recognition and treatment of septic patients. However, an enormous question remains when considering how to best implement these guidelines in settings with limited resources, which include rural US emergency departments and low- and middle-income countries. The core principles of sepsis management should be a priority in community emergency departments. Similarly, cost-effective interventions are key priorities in low- and middle-income countries; however, consideration must be given to the unique challenges associated with such settings.
我们对导致脓毒症的生理过程的不断深入理解,促使了共识指南的更新,这些指南概述了脓毒症患者识别与治疗的优先事项。然而,在考虑如何在资源有限的环境中最佳地实施这些指南时,一个重大问题仍然存在,这些资源有限的环境包括美国农村急诊部门以及低收入和中等收入国家。脓毒症管理的核心原则在社区急诊部门应是首要任务。同样,具有成本效益的干预措施在低收入和中等收入国家是关键优先事项;然而,必须考虑与此类环境相关的独特挑战。