Sepsis Protocol

Sepsis is defined as a state of complete inflammation of the body found to be associated with a known or suspected infection.

 

Sepsis is a spectrum, the patients start with more mild symptoms and progress to more severe symptoms. At the severe end is septic shock. The first category is Systemic Inflammatory Response Syndrome or SIRS.

 

The patient must have 2 or more of the following symptoms to be considered septic:

 

They have a temperature above 100.5 degrees Fahrenheit or less than 96.8 degrees Fahrenheit, a heart reate above 90, a respiratory rate above 20 or PaC02 less than 32 (normally it’s 40), WBCs greater than 12,000 or less than 4,000 or greater than 10% band cells. If they do have two or more of these present or infection, then the protocol for sepsis is put into place and notify the physician, charge nurse, and have a secondary screening done.

 

Severe sepsis is sepsis plus some symptoms of end organ damage, lactic acid greater than 4, or systolic BP below 90.

 

Septic shock means that the healthcare team has done things to treat the hypotension like IV fluid boluses, steroids, evaluated lactic acid and the patient still has hypotension and needs pressors. This is when the patient has organ damage potential

 

At Cottage Hospital, the policy for sepsis has a well-known acronym called SLAY SEPSIS. The first word stands for Sepsis, Lactate/Labs, Activate the team/Antibiotics, Yell for fluids.

 

The second word stands for Straight to critical care, Early goal-directed treatment, Pressors, Scv02 Monitoring, Insulin, and Source Control/Steroids.

 

It is important to recognize sepsis early when it is reversible and before it advances to septic shock and irreversible failure of multiple organ systems. In fact, early recognition is soon to be a core measure.

 

 

Sepsis Questions and Answers”. cdc.gov. Centers for Disease Control and Prevention (CDC). May 22, 2014. Retrieved 27 October 2015

 

Cottage Health (n.d.). SLAY SEPSIS Resuscitation Protocol.