ADULT SEPSIS / SEVERE SEPSIS CHECKLIST SIRS criteria (any 2): Severe sepsis criteria: Temp. <36oC or >38.3oC Heart rate > 90bpm Respiratory rate > 20bpm White cells <4 or >12 Organ dysfunction Eg. hypoxia, renal impairment, coagulopathy This patient is severely unwell and requires time critical treatment: Immediate resuscitation Hypotension (systolic <90mmHg) (See below) Senior review Source of infection (suspected / proven) : Date and time of diagnosis with severe sepsis: Can the source be controlled (eg surgery/drain)?: Y/N. If yes, this should be performed within 6 hours. Immediate management (use the sepsis tool box): Give Oxygen (as per NUH Oxygen policy) Blood culture (take 2 pairs from different sites) Lactate Lactate value……………… Antibiotics (Give these immediately – each hour delay increases mortality by 7.5%) Fluid bolus 20ml/kg crystalloid (If systolic BP<90mmHg or Lactate>2.0) Strict hourly input/output fluid balance chart and consider urinary catheter Have you called your: Consultant Registrar CCOT Nurses QMC (780 6339) NCH (780 7168) If blood pressure fails to improve following fluid bolus or if concerns remain: Request Critical Care review for consideration of HDU/ITU transfer (May need central line, vasopressors and higher level monitoring) Seen by: Dr Date: Signature : Time (24hr): Grade: Please insert into medical notes ©NUH 2012. Produced by W. Robson, M. Chikhani and M. Simmonds on behalf of the NUH Sepsis Action Group Critical Care Doctor QMC (784 3014) NCH (784 2062) Sepsis intranet website has further guidance. ADULT SEPSIS / SEVERE SEPSIS CHECKLIST SIRS criteria (any 2): Severe sepsis criteria: Temp. <36oC or >38.3oC Heart rate > 90bpm Respiratory rate > 20bpm White cells <4 or >12 Organ dysfunction Eg. hypoxia, renal impairment, coagulopathy This patient is severely unwell and requires time critical treatment: Immediate resuscitation Hypotension (systolic <90mmHg) (See below) Senior review Source of infection (suspected / proven) : Date and time of diagnosis with severe sepsis: Can the source be controlled (eg surgery/drain)?: Y/N. If yes, this should be performed within 6 hours. Immediate management (use the sepsis tool box): Give Oxygen (as per NUH Oxygen policy) Blood culture (take 2 pairs from different sites) Lactate Lactate value……………… Antibiotics (Give these immediately – each hour delay increases mortality by 7.5%) Fluid bolus 20ml/kg crystalloid Strict hourly input/output fluid balance chart and urinary catheter Have you called your: Consultant Registrar CCOT Nurses QMC (780 6339) NCH (780 7168) If blood pressure fails to improve following fluid bolus or if concerns remain: Request Critical Care review for consideration of HDU/ITU transfer (May need central line, vasopressors and higher level monitoring) Seen by: Dr Date: Signature : Time (24hr): Grade: Please insert into medical notes ©NUH 2012. Produced by W. Robson, M. Chikhani and M. Simmonds on behalf of the NUH Sepsis Action Group Critical Care Doctor QMC (784 3014) NCH (784 2062) Sepsis intranet website has further guidance.
© Copyright 2024 ExpyDoc
