Recognize & Activate
Sepsis and septic shock are emergencies. Treatment and resuscitation should begin at this time.
What is immediately?
The guidelines suggest measuring this blood marker in possible, probable, or definite sepsis.
What is lactate?
For possible, probable, or definite septic shock, give antimicrobials immediately, ideally within this interval.
What is 1 hour from recognition?
This fluid class is the first choice for sepsis resuscitation.
What are crystalloids?
For septic shock without concomitant cardiac dysfunction, this vasopressor is the first choice.
What is norepinephrine?
According to the facility's Code Sepsis Protocol, activation requires BOTH criteria.
What are known or suspected infections and a positive sepsis screen?
Collect these microbiology specimens promptly, ideally before antimicrobials
What are blood cultures?
For probable or definite sepsis without shock, the ideal antibiotic interval is this.
What is 1 hour from recognition?
For initial resuscitation, this crystalloid type is generally suggested over 0.9% saline.
What are balanced crystalloids?
This is the general initial MAP target for adults with septic shock.
What is 65 mm Hg?
A patient meets SIRS criteria when they have at least this many abnormal findings.
What are two or more SIRS criteria?
This is the adult blood volume listed in the facility collection checklist.
What is 8–10 mL?
Possible sepsis without shock warrants rapid investigation. If infection remains a concern, give antibiotics within this interval.
What is 3 hours from first suspicion?
True or false: keep giving fluids solely until an elevated lactate becomes normal.
What is false?
To avoid delaying therapy for central access, vasopressors may initially start through this access.
What is a peripheral IV?
Name the four SIRS criteria and their abnormal values.
Temperature >38°C or <36°C
Heart rate >90 bpm
Respiratory rate >20/min or PaCO₂ <32 mm Hg
WBC >12,000/mm³, <4,000/mm³, or >10% bands
With CHG/alcohol, use this scrub motion and minimum scrub and drying times.
What is back-and-forth for 30 seconds, then dry completely for at least 30 seconds?
When an infection requires source control, early intervention is suggested, ideally within this interval after diagnosis.
What is 6 hours?
This maneuver temporarily increases venous return and can assess fluid responsiveness when paired with stroke-volume measurement.
What is a passive leg raise?
When norepinephrine requirements rise, this additional vasopressor is suggested.
What is vasopressin?
For a pregnant or recently postpartum patient, name the four pregnancy-adjusted sepsis screening values.
Temperature <36°C or ≥38°C
Heart rate >110 bpm
Respiratory rate >24/min
WBC >15,000/mm³, <4,000/mm³, or >10% bands
You have insufficient blood for both culture bottles. Name the priority bottle and the maximum time to send cultures to the lab.
What is the aerobic bottle, with cultures sent within 1 hour?
Final cultures identify a susceptible organism. Narrowing therapy or stopping unnecessary agents is called this.
What is antimicrobial de-escalation?
In sepsis-induced hypoperfusion or septic shock, this minimum initial volume is suggested within 3 hours.
What is 30 mL/kg of IV crystalloid?
An adult has profound hypotension, mottling, and altered mentation. This medication class may start concurrently with IV fluids.
What are vasopressors?