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GP Vivasemergency-medicine

GP Vivas · emergency-medicine

Sepsis recognition and escalation from primary care — structured viva

Structured oral on sepsis: Sepsis-3 definitions, qSOFA limits, the Seymour time-to-antibiotics evidence, SSC 2021 fluid recommendations, SMART crystalloid data, and post-sepsis follow-up.

structured clinical oral2 min readVerification in progress

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
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Study tools

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'A patient with fever and a fast heart rate — why are you calling an ambulance rather than starting oral antibiotics?' The viva branches through definitions, recognition tools, the hour-one evidence, fluids and follow-up.

Stem

You are the GP. A colleague says oral antibiotics and review tomorrow would be fine. [3]

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You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the General Practice fellowship library.

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References7ShowHide
  1. [1]Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA, 2016.PMID 26903338
  2. [2]Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA, 2016.PMID 26903335
  3. [3]Seymour CW, Gesten F, Prescott HC, et al. Time to Treatment and Mortality during Mandated Emergency Care for Sepsis N Engl J Med, 2017.PMID 28528569
  4. [4]Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 Crit Care Med, 2021.PMID 34605781
  5. [5]Rudd KE, Seymour CW, Aluisio AR, et al. Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries JAMA, 2018.PMID 29800114
  6. [6]Brown RM, Wang L, Coston TD, et al. Balanced Crystalloids versus Saline in Sepsis. A Secondary Analysis of the SMART Clinical Trial Am J Respir Crit Care Med, 2019.PMID 31454263
  7. [7]Melero-Guijarro L, Sanz-García A, Martín-Rodríguez F, et al. Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study Front Med (Lausanne), 2023.PMID 37144037
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