Improving identification of sepsis

The Surviving Sepsis Campaign has created pocket guides, posters, bundle cards, and a list of resources to aid your implementation efforts using the most recent edition of the international sepsis guidelines.

Within 15 minutes

• Draw stat lactate
• Draw blood cultures & urine cultures

Within 1 hour

• Start Broad Spectrum IV antibiotics after the cultures are drawn
• Administer 30ml/kg crystalloid for hypotension or lactate ≥4mmol/L
• If initial lactate level is >2, draw a repeat lactate level within 4 hours of positive sepsis screen. (lactate order will be reflexed automatically)
• If hypotension persists after 30ml/kg bolus, or lactate ≥ 4 = Septic Shock Time
• Start IV vasopressors for persistent hypotension.
• Provider to perform focused exam within 4 hours of Septic Shock time 

Improving identification of potentially septic patients

To improve identification, it is recommended to have a consistent approach to every patient who is identified as meeting SIRs criteria. Use our prior posts on sepsis for more education (New Sepsis Guidelines) (Qsofa Score). It is also recommended to utilize a smart phrase to identify any potential infectious etiology and medical decision making to prevent missing a potential source of infection, such as an indwelling catheter or orthopedic device. 

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