Sepsis Info

Recommended!

See the following attachment for SEP-1 Definitions & Details. Information below is a summary of this attachment.

SEP 1

Sepsis Criteria

Pregnant = 20weeks to 3 days post partum

Pregnant

• Temp >38C or less than 36C

• HR >110 bpm

• RR >24/min

• WBC >15000, or 10% bands

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• Cr >1.2 mg/dL
• SBP less than 85 mm/hg or MAP less than 65

Non-Pregnant

• Temp >38.3C or less than 36C

• HR >90 bpm

• RR >20/min

• WBC >12000, less than 4000, or 10% bands

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• Cr >2.0 mg/dL
• SBP less than 90 mm/hg or MAP less than 65

3 Hour Bundle

Initial Lactate

• Greater than 2 = organ dysfunction.
• Order and document difficult access or patient refusal.

Blood Cultures Before Antibiotics

• Can be drawn after abx IF waiting would delay abx by 45+ minutes.
• Order and document difficult access or patient refusal.

Start Antibiotics

• Order and document difficult access or patient refusal.
• Can be given IM or IO only if difficult access is documented.

30 cc/kg IVF

(Only required for lactate >4, septic shock, or severe sepsis with initial hypotension.
NOT REQUIRED for severe sepsis alone)

• Order and document difficult access or patient refusal.
• May use ideal body weight if BMI > 30. Document IBW was used.
• LVADs are excluded.
• Document concern for CHF, pulm edema, ESRD, response to less fluid, etc.

6 Hour Bundle

Sepsis Focused Exam

(Only required for lactate >4, septic shock, or severe sepsis with initial hypotension.
NOT REQUIRED for severe sepsis alone)

• After IVF Started
• Document AND Time “I have performed a sepsis focused exam”

Start Vasopressors

(Only required for lactate >4, septic shock, or severe sepsis with initial hypotension.
NOT REQUIRED for severe sepsis alone)

• Only if patient hypotensive after IVF bolus.
• Order and document difficult access or patient refusal.

Repeat Lactate

• Only required if initial Lactate >2
• Order and document difficult access or patient refusal.