Sepsis Bundle
What should be given 1st when Severe or Septic Shock is present? Antibiotics or Sepsis fluids?
What is Antibiotics
Name 3 examples of SIRS
-Temperature >100.9F or <96.8F
-Heart Rate >90 beats per minute
-Respiration Rate >20 breaths per minute
-WBC >14,000 or <4,000
What are the two CMS recommended Sepsis Fluid Medications?
What is lactated ringers and normal saline
Triggers an automatic repeat LA
What is a Lactic Acid result >2?
This should be collected prior to antibiotic administration
What is a blood culture
What is the time frame to administer Antibiotics when Sepsis is suspected?
Within 1hr or up to 3hrs of suspected sepsis
An indicator for inadequate tissue perfusion
What is lactic acid?
A provider can document and order the 30ml/kg bolus based on this, if the patients BMI is greater than 30
What is Ideal Weight?
True or False- A Lactic Acid specimen must be placed in ice after collection?
True
This act creates the time stamp in EPIC for when a medication is administered
What is medication scan?
3hour Bundle include these four items
What is...
-Initial LA
-Blood Culture
-Antibiotics
-Fluids
Lactic acid >4 or persistent hypotension
What is septic shock?
Fluids should start within what time after knowledge of Severe Sepsis?
What is within 1 hour
What blood culture tube should be drawn 1st? Aerobic or anaerobic?
What is Aerobic- reason air may be in collection set.
Patients with persistent hypotension following fluid bolus need a medication from this drug class
What is Vasopressors?
Nurse action required post fluid administration and Physician action required post fluid administration
What is BP assessment and Focused Exam?
Three components of Severe Sepsis
What is
-SIRs
-Source of Infection
-Organ Dysfunction
What two indicators require a Sepsis Fluid Bolus?
What is Low BP and initial Lactic acid 4 or greater
Should a repeat lactic be drawn before or after the sepsis fluid bolus?
After the sepsis fluid bolus.
Preferred IV pressor to treat persistent hypotension
What is Levophed
Where in EPIC can the Sepsis Checklist be found? Nursing/MD
Nursing- What is Nurse Sepsis tab
Provider- What is Sepsis navigator, Sepsis Smart phrase (.spesischecklis)
Name at least 4 Organ Dysfunction elements
What is...?
-Lactate >2 -SBP <90/drop40pts
-Map <65 -Creatinine >2
-Total Bililrubin >2 -Platelets <100
-INR>1.5
What sepsis fluid should not be administered together with piperacillin (Zosyn)?
What is Lactated Ringers
Name 5 laboratory tests that can detect and identify infection and sepsis
What is
-Lactate
-Cultures- Blood,urine, sputum
-Procalcitonin
-CSF analysis
A broad spectrum antibiotic given to treat Sepsis
What is Ceftriaxone, Ceftazidime, Ampicillin/sulbactam, Piperacillin/tazobactam, or Levofloxin?