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Text: The Surviving Sepsis Campaign (SSC) published a 2021 update of its 2016 recommendations. The update was awaited with great anticipation the world over, especially by emergency physicians. Under the framework of the CIMU 2022 (33rd World Emergency Medicine Conference) in Guadalajara, Mexico in March, emergency physiciansreviewed and analyzed the 2021 SSC guidelines from our specialty's point of view. In this article, the expert reviewers present their consensus on certain key points of most interest in emergency settings at this time. The main aims of the review are to present constructive comments on 10 key points and/or recommendations in the SSC 2021 update and to offer emergency physicians' experience- and evidence-based proposals. Secondarily, the review's recommendations are a starting point for guidelines to detect severe sepsis in emergency department patients and prevent progression, which is ultimate goal of what has become known as the Guadalajara Declaration on sepsis.

The incidence of the coronavirus disease 2019 (COVID-19) in Latin America and Spain and its impact particularly on hospital emergency departments have been great, sustained, and unpredictable. Unfortunately, this situation will continue in the medium term, regardless of the diverse concepts and definitions used to identify cases or hypotheses about the role of staff. In the context of the worldwide pandemic, a multinational group of experts from the Latin American Working Group to Improve Care for Patients With Infection (GT-LATINFURG) has drafted various opinion papers for use by emergency care systems in the member countries. The GT-LATINFURG is comprised of representatives from the 13 scientific associations affiliated with the Latin American Federation for Emergency Medicine (FLAME). Experts from the Spanish Society of Emergency Medicine (SEMES) also participated. The present consensus statement offers protocols and recommendations to facilitate the work of hospital emergency departments with regard to key issues the group identified, namely, the need for reorganization, triage, and routine test availability. Additional issues discussed include biomarkers; clinical, laboratory, radiologic, and microbiologic criteria for identifying patients with COVID-19; and risk and prognostic factors for mortality that emergency staff can use to quickly detect severe cases in our settings.

En: Although infection rates and the impact of infection on hospital emergency departments (EDs) are known or can be reliably estimated, the incidence and prevalence of sepsis vary in relation to which definitions or registers used. Sepsis is also well known to be under-diagnosed by physicians in general and by ED physicians in particular. Over half of sepsis cases are community-acquired, and 50% to 60% of patients in intensive care units (ICUs) with sepsis or septic shock are admitted directly from the ED. Pneumonia and urinary tract infections are the most common points of focus in sepsis, septic shock, bacteremia, and ED admissions to the ICU for infectious processes. For this article a multinational group of experts representing Latin American emergency medicine associations reviewed and analyzed similarities and differences in the epidemiology of sepsis in different geographic locations. We consider key aspects and geographic similarities and differences in the early identification of patients with severe sepsis; criteria that define the diagnosis; appropriate early antibiotic and fluid therapy; the roles of triage systems and multidisciplinary sepsis code units; and the use of biological markers in this time-dependent disease. We also discuss key points and strategies for improving the diagnosis, prognosis, and care of sepsis patients in the ED.

Background: Cervical and endometrial measurement in the gynecological and obstetric patients is of vital importance. There is no consensus for the correct way in which should be made the measurement, more than anything is for an opinion of some experts., Objective: To determine whether there are differences in measurement of endometrial or sagittal cross section of the uterus and cervix in the measurement of fractional linear fashion or along the cervical canal., Material and Methods: Using a transvaginal ultrasound, was measured in a transverse and longitudinal endometrial lining. And by fractional measuring along the cervical canal and a linear manner from the internal to the external., Results: We studied a total of 63 patients. The mean endometrial transversal measurement in a cross was 7.1. mm (SD +/- 3.3) The mean endometrial longitudinally measured were: 7.9 mm (SD +/- 3.4). The mean cervical measurement was fractionally 3.3 cm (SD +/- 0.4) Mean cervical linear measurement was 3.9 cm (SD +/- 0.4). Using student's t test where the value of p in the endometrial measurement was 0.0871 and p value in cervical measurement was 0.009, the latter being statistically significant., Conclusions: With respect to the measurement of the endometrial lining, there is no significant difference do any of the two different techniques. However, measurement of the cervix, another significant difference (p = 0.009), so it should be further investigated which of these two techniques is the right way to establish more accurate diagnoses.