Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method

Sepsis may be managed outside a designated critical care area, with triggers for escalating clinical management and criteria for safe transfer to another facility

In the absence of serum lactate, clinical parameters such as altered mental status, capillary refill time and urine output may be used to guide resuscitation

Special considerations for resuscitation fluid volume, especially in tropical infections, incl. simple tests of fluid responsiveness when advanced hemodynamic monitoring is limited

Ringer's lactate or Hartmann's solution as balanced salt solutions

Epinephrine when norepinephrine or vasopressin are unavailable

Vasopressors via a peripheral vein if central venous access is unavailable or not feasible

Where investigation facilities are unavailable, empirical antimicrobials without delay when sepsis is strongly suspected

Empirical antiparasitic agents in patients with suspicion of parasitic infections