SOURCE CONTROL

GOAL: Eliminate the source of infection.

Some infection sources are treated only with antibiotics, while others may require surgery to remove or drain the infection source. A full patient exam should be performed to look for sources of infection that may not have been identified on the initial patient survey and serial exams should be performed as part of ongoing patient assessment to track physical signs of infection spread or response to therapy. With wound sepsis, quality wound care is critical to infection and sepsis treatment and prevention as previously detailed in the JTS Acute Wound Management - PFC CPG.

Any identified potential infection sources such as foreign bodies, old indwelling catheters (to include IV/IO, urinary, etc.) and dead or dying tissue must be evaluated and attended to immediately. All previously inserted urinary or other indwelling catheters and IV/IO catheters should be removed and replaced if possible. Those that are not needed to immediately care for the patient should be considered for removal. All wound dressings should be removed, and any sign of infection requires surgical wound exploration. All dead infected tissue must be removed, up to and including amputation when needed. Any abscesses or infected spaces must be completely drained. Any suspected intrathoracic or intraperitoneal infection sources must be attended to by a surgeon urgently. Always initiate antibiotics and fluid resuscitation prior to attempting surgical interventions.

Aggressive and adequate surgical source control is essential to the patient’s survival. Obtain telemedicine consultation from a surgeon.