Clinical Management of Urosepsis in Emergency Settings: Nursing Care, Nutritional Support, and EMS Interventions

Background: Urosepsis is a life-threatening systemic response to urinary tract infections resulting from a dysregulated host reaction leading to inflammation, tissue hypoperfusion, and organ dysfunction. It commonly arises from ascending infections such as pyelonephritis, complicated UTIs, and infections associated with urinary obstruction or indwelling catheters. Gram-negative bacteria, particularly Escherichia coli, are the predominant causative organisms.  Aim: This review aims to summarize current evidence on the clinical presentation, diagnostic workup, management strategies, and multidisciplinary roles in improving outcomes in urosepsis. Methods: The article synthesizes evidence from clinical trials, epidemiologic trends, and contemporary guidelines focusing on etiology, pathophysiology, diagnostic evaluation, emergency management, and interprofessional practices. Results: Urosepsis continues to exhibit high morbidity and mortality, with death rates reaching up to 40% despite advances in care. Early recognition, rapid initiation of antibiotics within one hour, and aggressive fluid resuscitation significantly improve survival. CT imaging is valuable in identifying obstructive or structural causes requiring source-control procedures such as stenting or nephrostomy. Complications include acute kidney injury, septic shock, and multiorgan dysfunction. Multidisciplinary collaboration, including infectious-disease pharmacists and urology specialists, enhances antimicrobial stewardship and improves outcomes.  Conclusion: Early diagnosis, prompt antimicrobial therapy, aggressive resuscitation, and timely correction of urologic abnormalities are essential for reducing mortality and long-term complications. Interprofessional coordination remains critical to optimal outcomes.