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Sepsis — Echocardiogram/Bedside US — Clinical Pathway: Emergency Department, Inpatient and PICU

Sepsis Clinical Pathway — Emergency Department, Inpatient and PICU

Echocardiogram/Bedside US

Do not delay initiation of vasoactive therapy to obtain cardiac function assessment.

  • Consider performing echocardiogram or bedside ultrasound to assess (as able) for:
    • LV and RV qualitative systolic function
    • Presence of pericardial effusion
    • Volume responsiveness
    • Severe RV dilation
  • Views to obtain on bedside US:
    • Parasternal long axis view
    • Parasternal short axis view
    • Apical 4 chamber view
    • Subcostal view
    • Transverse and longitudinal IVC views
      • An IVC: aorta ratio of < 1.2:1 suggests volume depletion
      • IVC diameter variability of > 50% in a non-intubated patient or > 15% in an intubated patient suggests the patient would be responsive to fluid

If systolic dysfunction present on bedside US, consult cardiology for expedited formal echo.

 

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