Protocol 53 - Adult Suspected Sepsis PDF

MEDICAL Protocol 53 ADULT SUSPECTED SEPSIS INITIAL MEDICAL CARE HISTORY SIGNS AND SYMPTOMS DIFFERENTIAL Duration and seve...

MEDICAL Protocol 53 ADULT SUSPECTED SEPSIS INITIAL MEDICAL CARE HISTORY SIGNS AND SYMPTOMS DIFFERENTIAL Duration and severity of fever Warm Infections: UTI, Pneumonia, Past medical history Flushed Skin/wound Medications / recent antibiotics Sweaty Cancer / Tumors / Lymphomas Immunocompromised (transplant, Chills/rigors Medication or drug reaction HIV, diabetes, cancer) Delayed cap refill Connective tissue disease: Arthritis, Indwelling medical device Vasculitis Mental status changes Last acetaminophen or ibuprofen Hyperthyroidism Recent hospital / healthcare facility ASSOCIATED SYMPTOMS Heat Stroke (helpful to localize source) Bedridden or immobile Meningitis Myalgia, cough, chest pain, Elderly and very young-at risk Hypoglycemia / hypothermia headache, dysuria, abdominal Prosthetic device / indwelling device pain, rash MI/CVA SEPSIS SCREEN: Pediatric SIRS Criteria Obvious or suspected source of infection AND any of these Temperature SIRS (Systemic Inflammatory Response Syndrome) criteria: Same as adult SBP < 90 mmHg AND Heart Rate > 90/minute Heart Rate Respiratory Rate > 20 1month – 1 year > 180 2 – 5 years > 140 GCS < 15 6 – 12 years > 130 Temperature > 100.4°F or < 96.0°F 13 – 18 years > 120 Sepsis Screen Establish IV/IO Positive? YES If SBP60 up to max 1000ml NO REASSESS SIRS CRITERIA I P May repeat additional NS bolus up to1000ml Exit to appropriate protocol to a max total of 2000ml as indicated as long as SIRS criteria present, unless concern with fluid overload. B EMT B For hypotensive pediatric patient, refer to I EMT-I I distributive shock in PEDIATRIC SHOCK PROTOCOL # 68 P Paramedic P SEPSIS ALERT Notify receiving facility during TRANSPORT Revised: 12/01/24 Effective: 05/01/98