Core Measures
A lactic acid greater than this value will require a repeat lactic in two hours.
2.0
Despite it being a vital sign, hypotension is not considered a symptom of SIRS (Systemic Inflammatory Response Syndrome). Instead, it is considered a symptom of this category.
End-Organ Dysfunction
This pop-up will flag in the patient's chart if patient triggers SIRS criteria.
Sepsis BPA
The amount of blood needed in all blood culture bottles for adults.
8-10ml
A fluid bolus should be administered within this many minutes.
60 min
A SBP less than _____ and/or a MAP less than ___ meets the definition of hypotension
90 and 65
The four components of SIRS (Systemic Inflammatory Response Syndrome)
Temp >38 or <36
HR > 90
RR > 20
WBC >12 or <4 or >10% bands
This tool can be found on the Nsite under Sepsis Program or located on the floor printed on green paper
The Sepsis Checklist
DOCUMENT inability to obtain.
This commonly considered chronic illness can trigger the “confirmed/suspected source of infection” starting the Severe Sepsis clock.
COPD
A medication from this drug class must be given within 3 hours of the Severe Sepsis clock start.
True or False
Even if the patient demonstrates no signs or symptoms of sepsis, if a physician documents "sepsis" or "severe sepsis" in the patient's chart, they are coded as a sepsis patient.
TRUE
This tool is located in EPIC and is used during nurse-to-nurse handoff.
Sepsis Sidebar
Fluid boluses started prior to this time, can not count toward the calculated total 30 ml/kg bolus.
3 hours prior to the Severe Sepsis clock start
The amount of time you have to document TWO blood pressures (with MAP) following a 30ml/kg fluid bolus.
Within one hour of the stop time.
Patients with persistent hypotension following 30ml/kg bolus, need a medication from this drug class ordered
Vasopressors
The difference between Sepsis & Severe Sepsis
Sepsis includes 2 SIRS + Source of Infection
Severe Sepsis includes Sepsis + End Organ Damage
If a patient has a positive sepsis screen in triage, this order set should be implemented
Suspected Sepsis Standing Orders
A provider can document and order the 30 ml/kg bolus based on this, if the patients BMI is greater than 30.
Ideal weight
This sign of organ dysfunction is not a trigger, if the patient has documented renal disease.
Creatinine > 2.0
The two triggers for a 30ml/kg fluid bolus.
1. Lactic greater than or equal to 4.0
2. Documented episodes of hypotension within 6hrs of the Severe Sepsis clock start (before or after)
The difference between Severe Sepsis and Septic Shock is...
Severe Sepsis - Sepsis + End Organ Damange
Septic Shock - Severe Sepsis + Hypotension
Located within the Summary tab of EPIC, this toolbar summarizes and color codes sepsis indicators for quick review
Sepsis Summary Toolbar
The provider can document one of these three things, if they feel that the 30 ml/kg bolus is not appropriate for a Severe Sepsis patient.
Patient/family refusal, end stage renal disease, or end stage heart disease
This is the definition of persistent hypotension.
Two or more episodes of hypotension within one hour of completing the ordered fluid bolus.