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In-Patient Sepsis Management Algorithm

This document outlines an in-patient sepsis algorithm for screening, assessing, and treating patients presenting with sepsis. It involves a 1 hour screening and medical review to check for signs of infection, organ dysfunction, or systemic inflammatory response. Based on the screen results, patients are either escalated for treatment of sepsis or follow usual care pathways. The treatment pathway involves completing a sepsis bundle within 1 hour, reviewing tests and differential diagnoses by 3 hours, and daily review of patient response and treatment.

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Ashly Nygil
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865 views1 page

In-Patient Sepsis Management Algorithm

This document outlines an in-patient sepsis algorithm for screening, assessing, and treating patients presenting with sepsis. It involves a 1 hour screening and medical review to check for signs of infection, organ dysfunction, or systemic inflammatory response. Based on the screen results, patients are either escalated for treatment of sepsis or follow usual care pathways. The treatment pathway involves completing a sepsis bundle within 1 hour, reviewing tests and differential diagnoses by 3 hours, and daily review of patient response and treatment.

Uploaded by

Ashly Nygil
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
  • In-Patient Sepsis Algorithm

In-Patient Sepsis Algorithm

(Exercising Clinical Judgment)

Sepsis Screen
NEWS ≥ 4 (or ≥ 5 on oxygen) and
suspicion of infection
Check for 1, 2 or 3
Screening and Medical Review – 1 hour

At risk of neutropenia, e.g. Systemic inflammatory


Clinical evidence of new
1 on chemotherapy/ 2 onset organ dysfunction
3 response (≥2 SIRS)
radiotherapy plus ≥ 1 co-morbidity

Actions Actions
Screen Positive Screen Negative

1. Escalate as per NEWS protocol


1. Follow usual management pathway
2. Place sepsis form with
2. Usual NEWS escalation protocol
documentation

Medical Review
History & examinations supports infection as likely cause of presentation
This is Time Zero

Urgent Anaesthetic/
Complete Give antimicrobials as per
By 1 hour

local antimicrobial guideline Critical Care review for:


Fluid resistant Shock,
Sepsis 6 Bundle Assess for
source control
Respiratory failure,
Purpuric rash

Assess patient’s clinical status

Review blood tests and other


Escalate for source control
investigations Review differential
Repeat lactate if 1st abnormal or Critical Care
diagnosis
as indicated
By 3 hours

Continue fluid resuscitation as indicated

Infection and organ Infection no organ Aetiology unclear +


dysfunction – dysfunction Organ dysfunction Non-infective aetiology
This is SEPSIS
This is INFECTION Continue IV antimicrobials STOP antimicrobials
On pressors –
This is SEPTIC SHOCK Usual treatment pathway until senior review

Complete and sign the Sepsis Form

Assess clinical, haematological and biochemical response to treatment


In-Patient Sepsis Algorithm Short Version - 27/08/2018
Daily Review

Follow local antimicrobial guideline

Deteriorating
Improving No change Urgent senior input.
Follow “Start Smart then Focus” Review diagnosis and treatment, Review diagnosis and treatment.
policy check for source control Consider microbiology review.
Consider Critical Care review.

In-Patient Sepsis Algorithm In-Patient Sepsis Algorithm Short Version - 27/08/2018 NEWS ≥ 4 (or ≥ 5 on oxygen) and suspicion

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