{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:03:47Z","timestamp":1780311827351,"version":"3.54.0"},"reference-count":59,"publisher":"Ordem dos Medicos","issue":"6-7","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>A s\u00e9psis \u00e9 uma emerg\u00eancia m\u00e9dica tempo-dependente, associada a elevada morbilidade e mortalidade. O reconhecimento precoce e a abordagem adequada no pr\u00e9-hospitalar s\u00e3o determinantes para o progn\u00f3stico. Apesar da exist\u00eancia da via verde de s\u00e9psis normatizada pela Dire\u00e7\u00e3o-Geral da Sa\u00fade, verificou-se a subnotifica\u00e7\u00e3o dos casos de suspeita de s\u00e9psis, urgindo a necessidade de revis\u00e3o dos crit\u00e9rios de alerta. Al\u00e9m disso, faltavam em Portugal orienta\u00e7\u00f5es espec\u00edficas para a sua ativa\u00e7\u00e3o e gest\u00e3o no contexto pr\u00e9-hospitalar. Por esse motivo, este artigo visa estabelecer recomenda\u00e7\u00f5es baseadas na evid\u00eancia para a uniformiza\u00e7\u00e3o do reconhecimento e tratamento da s\u00e9psis e do choque s\u00e9ptico no pr\u00e9-hospitalar portugu\u00eas, alinhadas com as orienta\u00e7\u00f5es internacionais mais recentes e com as capacidades operacionais do Sistema Integrado de Emerg\u00eancia M\u00e9dica. A presente orienta\u00e7\u00e3o t\u00e9cnica resultou de uma revis\u00e3o exaustiva da literatura, integrando consensos internacionais e adaptando-os \u00e0 realidade nacional. Deste modo, s\u00e3o definidos crit\u00e9rios de inclus\u00e3o e exclus\u00e3o para o alerta de s\u00e9psis em contexto pr\u00e9-hospitalar, priorizando a identifica\u00e7\u00e3o precoce atrav\u00e9s da suspeita de infe\u00e7\u00e3o ou altera\u00e7\u00f5es da temperatura e disfun\u00e7\u00e3o org\u00e2nica ou indicadores cl\u00ednicos de gravidade, como National Early Warning Score (NEWS)\/NEWS2 \u2265 5, \u00cdndice de Choque \u2265 0,7, Mottling \u2265 2, tempo de preenchimento capilar &gt; 2 segundos. O tratamento depende do tipo de meio interveniente, incluindo oxigenoterapia, posicionamento e controlo de temperatura para meios de suporte b\u00e1sico de vida; cristaloides balanceados, antipir\u00e9ticos parent\u00e9ricos e in\u00edcio precoce de suporte vasopressor para meios diferenciados, mediante algumas premissas para os meios de suporte imediato de vida. Recomenda-se ainda a antibioterapia emp\u00edrica nos casos de choque s\u00e9ptico abordados por meios com m\u00e9dico, nomeadamente Viaturas M\u00e9dicas de Emerg\u00eancia e Reanima\u00e7\u00e3o e Servi\u00e7o de Helic\u00f3pteros de Emerg\u00eancia M\u00e9dica. O documento uniformiza tamb\u00e9m os registos cl\u00ednicos e a ativa\u00e7\u00e3o de alertas atrav\u00e9s do iTeams\u00ae e do Verbete Nacional de Socorro. Esta primeira orienta\u00e7\u00e3o t\u00e9cnica nacional para a s\u00e9psis no pr\u00e9-hospitalar estabelece procedimentos uniformes e baseados na evid\u00eancia para o reconhecimento e tratamento precoces neste contexto, contribuindo para a melhoria dos resultados cl\u00ednicos, otimiza\u00e7\u00e3o de recursos e refor\u00e7o da articula\u00e7\u00e3o inter-hospitalar no \u00e2mbito da via verde de s\u00e9psis.<\/jats:p>","DOI":"10.20344\/amp.24178","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:05:33Z","timestamp":1777305933000},"page":"411-421","source":"Crossref","is-referenced-by-count":0,"title":["Abordagem \u00e0 V\u00edtima com Suspeita de S\u00e9psis ou Choque S\u00e9ptico: Recomenda\u00e7\u00f5es Cl\u00ednicas para o Contexto Pr\u00e9-Hospitalar Portugu\u00eas"],"prefix":"10.20344","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8007-1383","authenticated-orcid":false,"given":"Adelaide","family":"Moutinho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7711-640X","authenticated-orcid":false,"given":"F\u00e1bio","family":"Martins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2514-7730","authenticated-orcid":false,"given":"Joana","family":"Fontes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3838-8923","authenticated-orcid":false,"given":"Jos\u00e9","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0382-9968","authenticated-orcid":false,"given":"L\u00e9nia","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3163-2085","authenticated-orcid":false,"given":"Solange","family":"Mega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4656-4869","authenticated-orcid":false,"given":"Ana","family":"Vaz Cristino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0244-0803","authenticated-orcid":false,"given":"Eduardo","family":"Cernadas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1883-050X","authenticated-orcid":false,"given":"Francisco","family":"Abecasis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-3777","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Gon\u00e7alves Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0277-3309","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Jo\u00e3o Mendes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4879-559X","authenticated-orcid":false,"given":"Paulo","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0212-8414","authenticated-orcid":false,"given":"Paulo","family":"Mergulh\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6475-8302","authenticated-orcid":false,"given":"Ana Margarida","family":"Correia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8464","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"12780","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.82528"},{"key":"12781","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"12782","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006240"},{"key":"12783","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0000000000000552"},{"key":"12784","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa102"},{"key":"12785","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-024-01282-2"},{"key":"12786","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.31168"},{"key":"12787","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade. 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