Accuracy of Clinical Assessment in Predicting Source of Infection for Septic Patients in the Emergency Department

Many sepsis cases are first encountered in the Emergency Department (ED), and it is essential to identify and assess the severity of patient illnesses as well as their mortality risks as soon as possible after they present to the ED. The Sepsis Core Measure requires that clinicians rapidly screen patients and administer antimicrobial treatment within 3 hours of identification of severe sepsis and septic shock. Although much research has been done on the importance of early fluid administration, antimicrobial initiation, and hemodynamic resuscitation of septic patients, less is known about clinician ability to diagnose or predict the presumptive source of a septic patient's clinical syndrome. Despite limitations in patient presentation and physical findings, clinicians must make a scientific judgment for the potential source of infection and initiate appropriate therapy swiftly.