As Sepsis Awareness Increases and Guidelines Change, Timing Remains Crucial
By Amanda Anderson, a critical care nurse and graduate student in New York City who is currently doing a graduate placement at AJN two days a week.
September was Sepsis Awareness Month, but the urgency of the issue didn’t disappear when the month ended. I still remember my first day in the medical intensive care unit (MICU) I’d soon call home. I was shadowing the charge nurse, and an admission had just come in from the ED.
“Here, we need a CVP setup.” A crinkly bag of normal saline and a matching package containing something evidently important were shoved into my hands—a medical football passed to the only open player.
Very quickly, I would learn what a CVP, or central venous pressure, was and to monitor it. I would learn all about sepsis, and septic shock, and the treatment of its devastating process. Multiple organ dysfunction syndrome (MODS) was a primer for my care in this unit, and on my first day off of orientation, I was entrusted with one of its full-blown victims: Septic shock from pneumonia, causing respiratory, renal, and heart failure. Learning to spike a bag of saline for a CVP transducer was just my first step into the vast and complicated land of sepsis management.
This was 2007. Sometimes, as in all hospitals, care was delayed and septic patients sat without timely treatment for hours. Back then, we tubed people, snowed people, and flooded people. […]