...QUICK assessment of patient suspected to have developed sepsis can be done using the mnemonic:
S - Slurred speech
E - Extreme shivering or muscle pain
P - Passing no urine in a day
S - Severe breathlessness
I - I feel like I might die
S - Skin mottled or discoloured
P.S. IMMEDIATE MANAGEMENT by Sepsis Six: Give 3 things and take 3 things: Give oxygen, take blood for culture sensitivity, give antibiotics, take sample for lactate, arterial blood gas and other lab tests, give fluid challenge and take urine output measurement.
EARLY IDENTIFICATION by nurses and doctors is important to prevent severe sepsis, multiple organ failure and death.
A - Airway: Acute deterioration, possibly of airway as well.
B - Breathing: Septic focus somewhere like pneumonia; respiratory rate greater than 21 breaths/min requiring oxygen to keep SpO2 above 92%.
C - Circulation: Not passed urine in the last 12-18 hours or less than 0.5 ml/kg/hour. Systolic blood pressure below 90 -100 mm Hg or dropped by 40 mm Hg below the patient's baseline. Heart rate going above 90-130 beats/min and lactate above 2 mmol/L. ECG showing new dysarrhythmia. Is acute injury present?
D - Disability: Unresponsive or responding only to verbal command or painful stimulus. Confused acutely or having meningitis and relatives feeling concerned.
E - Exposure: Mottled skin with non blanching rash or looking ashen or cyanotic. Cellulitis, septic joints, infected wound, device related infection, urinary tract infection, immunosuppressed, history of recent chemotherapy, trauma or surgery in the last 6 weeks. Abdominal pain or distension and hyperpyrexic or hypothermic with temperature below 36 degree Celsius.
Sepsis protocol:
https://sepsistrust.org/wp-content/uploads/2017/08/ED-adult-NICE-Final-1107.pdf
Promoting early identification of sepsis in hospitalized patients with nurse-led protocols:
https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1590-0
NICE guidelines:
https://www.nice.org.uk/guidance/ng51/documents/sepsis-the-recognition-diagnosis-and-management-of-severe-sepsis-final-scope2
Early Recognition and Management of Sepsis in Adults: The First Six Hours:
https://www.aafp.org/afp/2013/0701/p44.html
Management of Sepsis: Overview:
http://www.frca.co.uk/article.aspx?articleid=100484
S - Slurred speech
E - Extreme shivering or muscle pain
P - Passing no urine in a day
S - Severe breathlessness
I - I feel like I might die
S - Skin mottled or discoloured
P.S. IMMEDIATE MANAGEMENT by Sepsis Six: Give 3 things and take 3 things: Give oxygen, take blood for culture sensitivity, give antibiotics, take sample for lactate, arterial blood gas and other lab tests, give fluid challenge and take urine output measurement.
EARLY IDENTIFICATION by nurses and doctors is important to prevent severe sepsis, multiple organ failure and death.
A - Airway: Acute deterioration, possibly of airway as well.
B - Breathing: Septic focus somewhere like pneumonia; respiratory rate greater than 21 breaths/min requiring oxygen to keep SpO2 above 92%.
C - Circulation: Not passed urine in the last 12-18 hours or less than 0.5 ml/kg/hour. Systolic blood pressure below 90 -100 mm Hg or dropped by 40 mm Hg below the patient's baseline. Heart rate going above 90-130 beats/min and lactate above 2 mmol/L. ECG showing new dysarrhythmia. Is acute injury present?
D - Disability: Unresponsive or responding only to verbal command or painful stimulus. Confused acutely or having meningitis and relatives feeling concerned.
E - Exposure: Mottled skin with non blanching rash or looking ashen or cyanotic. Cellulitis, septic joints, infected wound, device related infection, urinary tract infection, immunosuppressed, history of recent chemotherapy, trauma or surgery in the last 6 weeks. Abdominal pain or distension and hyperpyrexic or hypothermic with temperature below 36 degree Celsius.
Sepsis protocol:
https://sepsistrust.org/wp-content/uploads/2017/08/ED-adult-NICE-Final-1107.pdf
Promoting early identification of sepsis in hospitalized patients with nurse-led protocols:
https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1590-0
NICE guidelines:
https://www.nice.org.uk/guidance/ng51/documents/sepsis-the-recognition-diagnosis-and-management-of-severe-sepsis-final-scope2
Early Recognition and Management of Sepsis in Adults: The First Six Hours:
https://www.aafp.org/afp/2013/0701/p44.html
Management of Sepsis: Overview:
http://www.frca.co.uk/article.aspx?articleid=100484
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