Sepsis remains the 9th leading cause of disease-related death and the primary cause of infection-related death in the ICU. Sepsis is a devastating disease that results in over 250,000 deaths and 1.3 million hospitalizations per year. In February 2016, the Third International Consensus on Sepsis published “Sepsis 3.0,” the first new sepsis guidelines since 2003. The new guidelines were welcomed by many since the long interval time since “Sepsis 2.0,” but have already created a firestorm of controversy especially in emergency medicine. Much of this controversy is due to the move away from the systemic inflammatory response syndrome (SIRS) criteria in favor of the sequential organ failure assessment score (SOFA) and qSOFA scores. I encourage everyone to read the three excellent articles published by the “Sepsis 3.0” consensus group in the Journal of the American Medical Association (JAMA). My “go-to” sepsis apps remain ESCAVO Sepsis, Smart Intern Sepsis, and Sepsis Timer.

The “old” sepsis guidelines, as well as current guidelines and recommendations from the Surviving Sepsis Campaign, discuss indications for invasive monitoring of fluid status and hemodynamics. Previously guidelines all but mandated the use of a central line or other similar but less invasive monitoring. However, some of the large randomized controlled trials such as PROCESS, ARISE, and SEPSISPAM trials have called those practices into question — since, for the most part, they seemed to “contradict” the results of the initial Rivers Trial. Nonetheless, these monitors are still utilized today in ICU’s all over the world, and the learning curve can be steep. Edwards Lifesciences is a world leader in the production of these types of devices, including ClearSight and FloTrac, and they also are a leading in education about hemodynamic monitoring by both invasive and minimally invasive methods. The most recent version of their Edwards Lifesciences Clinical Education app has been released and it is the perfect companion to their devices. The app contains everything you need to become comfortable with the use of these devices as well as the basics of fluid status anatomy/physiology and the interpretation of data gathered from their devices.

Evidence-based medicine

Edwards Clinical Education comes from Edwards Lifesciences company who provides both education as well as manufactures advanced hemodynamic monitoring devices for fluid management in conditions such as sepsis. The information is clearly from the manufacturer but is evidence-based, well-written, and easy to understand for beginners as well as ICU attendings. The material can be used for residents just starting an ICU rotation, nurses new to hemodynamic monitoring or anyone who may have not previously encountered their devices such as the ClearSight or FloTrac. A few studies are mentioned, but few true references are provided. However, full CME like lectures are included on a variety of topics related to anatomy, fluid management, sepsis, etc. and are of high quality.

Who would benefit from this medical app?

Nurses, students, residents, mid-levels, primary care providers, emergency medicine, internal medicine, and hospitalist/ICU providers, or any provider who places and/or uses advanced hemodynamic monitors or wants to learn more about the topic.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.