Sepsis Update 2025

📧 EM Note Newsletter https://forms.gle/8boToiKDXVE3V8U19 Signup to get free weekly PDF via email. PS: Please join our membership for more perks (members can request for specific PDF file by posting in the EM Note YouTube Membership section). Homepage: EMNote.org ■ 🚩Membership: https://tinyurl.com/joinemnote 🚩ACLS Lecture: https://tinyurl.com/emnoteacls This lecture outlines the significant movement toward more nuanced and patient-specific sepsis protocols, detailing both shifts in resuscitation strategies and antibiotic stewardship. Key changes include the abandonment of several long-standing dogmas, such as treating the 30 mL/kg fluid guideline as a mandate and strictly chasing lactate clearance targets, which are now considered less reliable markers of perfusion. Instead, new evidence supports the early initiation of vasopressors (like norepinephrine) and promotes reliance on practical tools like SIRS and NEWS scores over complex predictive models for rapid screening. While the sources unanimously emphasize that timely antibiotic administration is critical to mitigate rapidly escalating mortality risk, they stress that speed must be balanced with prudent stewardship to ensure appropriate therapy selection and duration. Furthermore, clinical evidence now formally recommends against intravenous Vitamin C in septic shock due to potential harm, solidifying a focus on established therapies like corticosteroids, which are effective only in the presence of established shock.