Patient selection: hospitalized patient with severe CAP
Acronym: REPIC (which is a term in the card game Piquet)
Components of the care bundle:
(1) risk assessment (R)
(2) early fluid resuscitation (E)
(3) prompt oxygenation (P)
(4) immediate combination antibiotic therapy (I)
(5) consider ICU admission if high risk (C)
Risk assessment may include:
(1) pulse oximetry
(2) blood lactate
(3) prognostic score such as CAP PIRO
(4) consideration of comorbidities
(5) detection of bacteremia
(6) identification of causative pathogen(s)
Early triage to the ICU in high-risk patients should be considered. Delayed admission to the ICU is associated with reduced survival.
