Sepsis 3.0

This episode is a total revamp of the previous episode on sepsis.  If you go back to the original post on Sepsis, you’ll also find it replaced as well with this new episode.

A lot has changed with sepsis management since I published the sepsis episode in February 2012 so it was time for a complete overhaul.  The new sepsis guidelines have been out for about a year and I finally got around to updating the episode.  The new Surviving Sepsis Guidelines also just came out in a few months ago and those recommendations are included as well.  This episode will discuss the recognition of sepsis, how to do a good physical exam and ask the right history questions, order the right tests, and aggressively resuscitate these very sick patients.

There is also a separate episode that discusses the old sepsis definitions and how you can use that framework to recognize sepsis.

Sepsis 3.0 podcast

Old Sepsis definitions podcast (mini-episode)

Sepsis 3.0 March 2017 Show Notes (Word Format)

Sepsis 3.0 Updated March 2017 Show Notes (PDF)


Links mentioned during the show:


The original Rivers Trial

Rivers Early Goal Directed Therapy for Sepsis Original Study (Free access)

EM Basic Essential Evidence Episode on the Rivers Trial


Primary Literature- Free Open Access

New Sepsis Definitions (2016)

New Surviving Sepsis Campaign Guidelines (Published January 2017)


Blogs/podcasts discussing the new Sepsis Guidelines

EmCrit on New Sepsis Definitions (2016)

FOAMcast on the New Sepsis Definitions (2016)

FOAMcast on the New Surviving Sepsis Guidelines (2017)

Practical Evidence (EmCrit with Jeremy Faust) on the New Surviving Sepsis Guidelines (2017)

PulmCrit/EmCrit on the Surviving Sepsis “Myths” (2017)


Ashley Shreeves on Palliative Care in the ED (amazing talks- a must listen)

-Emcrit (Talking with families)

-Emcrit (Nuts and bolts of Critical Care Palliation)

-SMACC Chicago

-SMACC Dublin


ARISE, PROMISE, and PROCESS Trial Analyses

Emcrit on ARISE

The Bottom Line on PROMISE



Fluid Tolerance

EmCrit on Fluid Tolerance/Fluid Responsiveness

The Ultrasound Podcast with lots of episodes on Fluid Responsiveness


Peripheral Pressor Safety and Extravasation

EmCrit on Vasopressor Extravasation

PulmCrit on Safety of Peripheral Pressors


Intubation in Sepsis- low dose sedatives, high dose paralytics

EmCrit on Intubating Shocked Patients


Note: If there are any other good resources out there that you think should be included, email me at and I’ll include them.


Don’t forget about our bandwidth sponsor, EB Medicine.  Check out there numerous resources on ED sepsis care and critical care as well.  Residents can get free access and attendings can get a discount at the EM Basic EB Medicine page.