Abstract

CANDEL, F. J. et al. Detection and initial management of the systemic inflammatory response syndrome in medicine emergency room: 24 hours follow-up in a general hospital. An. Med. Interna (Madrid) [online]. 2008, vol.25, n.5, pp.205-208. ISSN 0212-7199.

Introduction: Systemic Inflammatory Response Syndrome (SIRS) is a clinical situation frequently observed in Emergency Room (ER). Its early detection and supporting measures improve prognosis of these patients. Aims: To know the incidence of SIRS among patients who come to ER, their frequency and distribution factors and the clinical evolution at 3 and 30 days. Patients and methods: Observational prospective simple-blind study. During 24 hours, SIRS was detected by observant doctors with an independent registry. Their management was observed. Patients from Obste-trics and Traumatology were not observed. Follow-up was done using telephonic and informatical techniques at 3 and 30 day. A descriptive analysis was done. Results: There were 163 patients attended in ER; 25 of them with SIRS (15.3%), 16 were male (65%) and 9 female (35%). By ages 8 were under 30, 4 were between 30 and 60 and 13 were over. The respiratory rate was not measured in 12 of the 25 patients with SIRS (48%). An infectious etiology (sepsis) was found in 19 of those 25 (76%) patients. The most frequent criterion of sepsis was tachycardia, followed by leukocyte disorders. Support of volume and antimicrobial therapy were only started at once in 21 and 42% respectively on patients with sepsis. 15 of 25 were admitted (2 in ICU). After 3 days, 11 of 25 remained at hospital and after 30 days 2. Conclusions: SIRS is a prevalent situation in ER with a high percentage of admissions. Most of SIRS were of infectious origin (sepsis). Major attention is needed among physicians to establish a promptly diagnose and starting support measures that improve their prognosis.

Keywords : SIRS; Sepsis; Septic shock; Emergency room.

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