Adult Suspected Sepsis Protocol 53

What is the maximum total amount of normal saline (NS) that can be administered to a patient under specific conditions?

What action should be taken if the SIRS criteria are reassessed and still present?

Which situation would necessitate exiting to an appropriate protocol?

When dealing with a hypotensive pediatric patient, what protocol should be referred to?

What must be done during transport if a sepsis alert is triggered?

Which of the following is NOT a sign of suspected sepsis?

What is the heart rate criterion for the SIRS criteria in adults?

Which symptom is associated with a higher risk of developing sepsis?

Which associated symptom could help localize the source of infection in suspected sepsis?

In which situation would a positive sepsis screen be most likely?

What is the recommended action if the sepsis screen is positive?

Which of the following conditions would NOT typically lead to a suspicion of sepsis?

Which vital sign alteration would indicate a child meeting SIRS criteria?

Adult Suspected Sepsis Protocol 53

History: Fever duration and severity, past medical history, recent antibiotics, immunocompromised status (transplant, HIV, diabetes, cancer), indwelling medical devices, recent use of acetaminophen or ibuprofen, recent hospitalizations, bedridden/immobile status, elderly/young at risk, prosthetic devices or indwelling devices
Signs and Symptoms: Warmth, flushed skin, sweating, chills, delayed capillary refill, mental status changes
Associated Symptoms (helpful to localize source): Myalgia, cough, chest pain, headache, dysuria, abdominal pain, rash
Differential Diagnosis: Infections (UTI, pneumonia, skin/wound), cancer, medication/drug reaction, connective tissue disease (arthritis), vasculitis, hyperthyroidism, heat stroke, meningitis, hypoglycemia/hypothermia, MI/CVA
Sepsis Screening: Presence of obvious or suspected infection source, And/or any of the following Systemic Inflammatory Response Syndrome (SIRS) criteria; low blood pressure (systolic blood pressure <90 mmHg), elevated heart rate (>90 beats per minute), elevated respiratory rate (>20 breaths per minute), low Glasgow Coma Scale score (<15), high temperature (>100.4°F or <96.0°F)
Sepsis Screen Positive: Establish an IV/IO line, if systolic blood pressure is below 90 mmHg or mean arterial pressure is below 60 mmHg, administer normal saline (NS) boluses to maintain SBP >90 and MAP>60, up to a maximum of 1000 ml. Repeatedly reassess SIRS criteria, potentially administering additional NS boluses up to a maximum total of 2000 ml, until concern over fluid overload, but keep treating if SIRS criteria remains present
Sepsis Screen Negative: Exit to appropriate treatment protocol as needed

Pediatric SIRS Criteria

Temperature: Same as adult criteria
Heart Rate:
1 month to 1 year: >180
2 to 5 years: >140
6 to 12 years: >130
13 to 18 years: >120
Distributive Shock in Pediatric Patients: Refer to protocol #68
Sepsis Alert: Notify receiving facility during transport

Dive into the critical aspects of recognizing and managing suspected sepsis in adults. This quiz covers history, signs, symptoms, differential diagnoses, and sepsis screening strategies. Perfect for healthcare professionals and students keen on emergency medicine.