SIRS Criteria
Sepsis Terminology
Sepsis Passport
100

SIRS: Greater than 90

Heart Rate

100

2+ SIRS, organ dysfunction, confirmed infection

Severe Sepsis

100

A critical Lactate Value is ____ or higher

2

200

SIRS: Greater than 20

Respiratory Rate

200

SIRS

Systemic inflammatory response syndrome

200

Draw ________ before antibiotics are initiated (Notify MD if unable to obtain)

Blood cultures

300

SIRS: Less than 96.8 or greater than 100.4

Temperature

300

2+ SIRS criteria

Sepsis

300

If initial Lactate is >4 or systolic BP is less than 90, fluids will be calculated at ___ ml/kg

30

400

SIRS: >12,000 or <4,000

White Blood Cells (WBC)

400

2 or more organ systems failing

MODS (multiorgan dysfunction syndrome)

400

If Lactate is >2, redraw in ___ to 4 hours.

2

500

Other recognizable symptoms of sepsis can include:

Change in mental status, shivering, pain, pale skin, sleepiness, impending doom, shortness of breath

500

2+ SIRS, organ dysfunction, confirmed infection, persistent hypotension

Septic Shock

500

The Sepsis ______ is a handoff tool to help facilitate care based on physician's orders.

Passport
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