This podcast is an interview with Dr. Anne Dabrow Woods, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital. The discussion is around COVID-19 and the resulting surge of patients overwhelming the healthcare system. In some areas, hospitals have increased their bed capacity to accommodate more patients, which brings up the question – who will care for these patients? Dr. Woods shares specific recommendations for strategies to increase staff quickly, including alternative staffing and onboarding models.

*Note: this podcast was recorded on March 26, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the CDC and WHO, plus free access to our point-of-care tools and more.

Listen in as Megan Doble, DNP, FNP-C, AGACNP-C, reviews the basics of sepsis and the latest recommendations on managing patients with sepsis. 

By remaining up to date on the latest research and recommendations, nurses can recognize subtle clinical changes that are the precursors to sepsis and best advocate for patients. 

Dr. Doble discusses:
*Current definitions related to sepsis
*Sepsis pathophysiology
*Patient care recommendations

The take home message is recognizing sepsis as a medical emergency, as early recognition and treatment can prevent death. 

References:
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., Belley-Cote, E., … Levy, M. (2021). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive care medicine, 47(11), 1181–1247. https://doi.org/10.1007/s00134-021-06506-yv

Levy, M. M., Evans, L. E., & Rhodes, A. (2018). The Surviving Sepsis Campaign Bundle: 2018 update. Intensive care medicine, 44(6), 925–928. https://doi.org/10.1007/s00134-018-5085-0   

Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., Kumar, A., Sevransky, J. E., Sprung, C. L., Nunnally, M. E., Rochwerg, B., Rubenfeld, G. D., Angus, D. C., Annane, D., Beale, R. J., Bellinghan, G. J., Bernard, G. R., Chiche, J. D., Coopersmith, C., De Backer, D. P., … Dellinger, R. P. (2017). Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive care medicine, 43(3), 304–377. https://doi.org/10.1007/s00134-017-4683-6

Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J. D., Coopersmith, C. M., Hotchkiss, R. S., Levy, M. M., Marshall, J. C., Martin, G. S., Opal, S. M., Rubenfeld, G. D., van der Poll, T., Vincent, J. L., & Angus, D. C. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), 801–810. https://doi.org/10.1001/jama.2016.0287

Transcript

For more sepsis resources, visit Focus On: Sepsis. 

In healthy patients, most fluids are confined in three spaces of the body: the intravascular space (in the blood vessels), the intracellular space (in the cells), or the interstitial spaces. The interstitial spaces are the small spaces between cells that are not contained within blood vessels. In normal situations, fluid moves between all three spaces to maintain fluid balance. Third-spacing occurs when too much fluid moves from the intravascular space into the interstitial or “third” space.

Reference:
Holcomb, S. (2009). Topics in Progressive Care: Third-Spacing: When Body Fluids Shifts. Nursing in Critical Care, 4(2). doi: 10.1097/01.NURSE.0000325345.22694.44

Carolyn Ackerman Ed.D MS RN CHPN, is from Arvada, Colo., and has almost 40 years of experience in home health and hospice. Not only is Ackerman a registered nurse, but she is also an assistant professor at Regis University in Denver, and she is very involved in end-of-life interdisciplinary simulation. Ackerman recently graduated from Creighton University with her Ed.D in interdisciplinary education. She created an end-of-life board game called The Path of Life: The Journey of Living at the End-of-Life © game, where participants assume the role of the patient as they make decisions related to their terminal disease.


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