Sepsis Kimberley style: Fluid Management by Dr James Wright

Welcome back – I have had a few weeks away from Broome and back to the job today.

This video (VODCAST) is a follow on from the recent ACEM Winter Symposium presentation we did with the Broome ED JMOs.

This episode is part 2 – should follow on from Dr Laura Smith’s case and outline.

Dr James Wright is another Manchester refugee here in Broome.  Always keen to get involved – he tackled the somewhat controversial and rapidly moving target of septic shock fluid management.

Not an easy ask to do in 8 minutes – but he did and I think it is a pretty good snapshot of the state of the evidence and a ractical “How-to” guide for the small ED with limited resources.

So here it is – watch out for episode #3 coming soon – in which we go over the use of Lactate in sepsis  – even more controversy to cover!

Enjoy Dr Wright’s PK here:



  1. Daniel Lichtenstein has suggested combining leg raise with ultrasound of the chest. You raise the patients legs and give fluids till you get B lines appearing in the chest. You then stop the fluids, lower the legs and the B lines (hopefully) disappear. At this point, additional fluid will just flood the lungs so if they are still in shock, he argues it is time to start the norad.

  2. Thanks for such a clear and concise approach. Do you have the links or references for ultrasound ij assessment for fluid responsiveness please?

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