Summary
Recommendations of the GT-LATINFURG for the identification and initial management of patients with severe infection and sepsis in emergency departments
Agustín Julián-Jiménez1-3, Darío Eduardo García2,4, Juan González del Castillo1,5, Raffo Escalante-Kanashiro66, Francisco Javier Candel González1,7, Graciela Merinos-Sánchez2,8, Ángel Estella1,9, Diego Armando Santillán-Santos2,8, Julio Javier Gamazo del Río1,10, Matías José Fosco2,11, Ferrán Llopis-Roca1,12, Luis Antonio Gorordo-Delsol2,13, Raúl López Izquierdo1,14, Marcelo Rodrigo Rodríguez2,15, Rafael Rubio Díaz1,3, Helio Penna Guimarães2,16, Luis García de Guadiana-Romualdo17, Ricardo Bañuelos Huerta2,18, Gema Delgado Cárdenas1,19, Ulises González-Bascuñán2,20, Rocío Lorenzo Álvarez1,21 Regina Gualco2,4, Marcio Borges Sa22,23, en representación del grupo de trabajo de Sepsis del GT-LATINFURG, Grupo de trabajo para la mejora de la atención al paciente con infección en el Servicio de Urgencias de la Federación Latinoamericana de Medicina de Emergencias (FLAME) y de la Sociedad Española de Medicina de Urgencias y Emergencias (INFURG-SEMES)
Affiliation of the authors
1SEMES: Grupo de trabajo de Infecciones de la Sociedad Española de Medicina de Urgencias y Emergencias. 2FLAME: Federación Latinoamericana de Medicina de Emergencias.3Servicio de Urgencias, Complejo Hospitalario Universitario de Toledo, IDISCAM (Instituto de Investigación Sanitaria de Castilla La Mancha), Toledo, Spain. 4Hospital de Alta Complejidad El Cruce, Florencio Varela, Buenos Aires, Argentina. 5Servicio de Urgencias, Hospital Universitario Clínico San Carlos, IDISSC & IML, Madrid, Spain. 6Unidad de Cuidados Intensivos, Oficina de Gestión de la Calidad, Instituto Nacional de Salud del Niño, Lima, Peru. Universidad Peruana de Ciencias Aplicadas, Escuela de Medicina, Lima, Peru. 7Servicio de Microbiología Clínica, Hospital Universitario Clínico San Carlos, IDISSC & IML, Madrid, Spain. 8Servicio de Urgencias Médico Quirúrgicas, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México, Mexico. 9Servicio de Urgencias, Hospital Universitario de Jerez, Cádiz, Departamento de Medicina Universidad de Cádiz, INIBiCA, Spain. 10Servicio de Urgencias, Hospital Universitario de Galdakao-Usansolo, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain. 11Servicio de Urgencias, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina. 12Servicio de Urgencias, Hospital Universitari de Bellvitge, l’Hospitalet de Llobregat, Barcelona, Spain. 13Unidad de Cuidados Intensivos Adultos, Hospital Juárez de México, Ciudad de México, Mexico. 14Servicio de Urgencias, Hospital Universitario Río Hortega de Valladolid, Spain. 15Departamento de Emergencias, Hospital Universitario Austral, Buenos Aires, Argentina. 16Hospital Israelita Albert Einstein, São Paulo, Brasil. 17Servicio de Análisis Clínicos, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain. 18Servicio de Urgencias, Hospital General Tlaxcala “Lic. Anselmo Cervantes Hernández”, Tlaxcala, Mexico. 19Servicio de Urgencias, Hospital Universitario de Fuenlabrada, Madrid, Spain. 20Hospital de Urgencia Asistencia Pública, Santiago de Chile, Chile. 21Servicio de Urgencias, Hospital de La Axarquía, Vélez-Málaga, Málaga, Spain. 22Unidad Multidisciplinar de Sepsis, Servicio Medicina Intensiva, Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain. 23Grupo Multidisciplinar de Sepsis, Instituto de Investigación sanitaria de las Islas Baleares, (Idisba), Spain.
DOI
Quote
Julián-Jiménez A, García DE, González del Castillo J, Escalante-Kanashiro R, Candel González FJ, Merinos-Sánchez G, et al. Recommendations of the GT-LATINFURG for the identification and initial management of patients with severe infection and sepsis in emergency departments. Emergencias. 2026;38:27-63
Summary
In November 2021, the Surviving Sepsis Campaign (SSC) published an update to its 2016 guidelines and recommendations. Subsequently, during the CIMU 2022 (33rd World Congress on Emergency Medicine, held in March 2022 in Guadalajara, Mexico), the 2021 SSC Guidelines were reviewed and analyzed from the perspective of
emergency physicians (EPs). The experts involved in this task also reached consensus and published several key points of greatest interest and concern to EPs regarding the management of patients with severe infection or sepsis in hospital emergency departments (EDs). These points included several improvement proposals developed by GTLATINFURG (Latin American Working Group for Improving Infection Care in Emergency Departments) and formally
presented in what became known as the “Guadalajara Declaration.” That document outlined complementary or alternative considerations to the 2021 SSC Guidelines. The first proposal was to “develop guidelines aimed at detecting, preventing progression, and managing patients with severe infection and sepsis in EDs.” Since then—and owing to numerous original research studies and review articles published by the GT-LATINFURG and INFURG-SEMES groups (Infection Study Group of the Spanish Society of Emergency Medicine)—we can now claim that there is scientific evidence generated in EDs themselves, or at least that existing evidence has been reviewed while considering the specific role of EPs. The main aim of this consensus document, as the initial presentation of the first
proposal of the Guadalajara Declaration, is to analyze—based on routine clinical practice, experience, available evidence, and the perspective of ED physicians—several key issues and controversies in order to establish recommendations through expert consensus grounded in current scientific evidence.