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Screening Patients for Severe Sepsis

Source: www.xigris.com
Topic: Sepsis
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Sort Desciption: A patient who meets the following 3 criteria has a positive screen suggestive of severe sepsis: ...

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A patient who meets the following 3 criteria has a positive screen suggestive of severe sepsis: INFECTION Does your patient have one or more of the following infection criteria? ® Documented or Suspected Does the patient have positive culture results (from blood, sputum, urine, etc.)? ® Anti-Infective Therapy Is the patient receiving antibiotic, antifungal, or other anti-infective therapy? ® Pneumonia Is there documentation of pneumonia (x-ray, etc.)? ® WBCs Have WBCs been found in normally sterile uid (urine, CSF, etc.)? ® Perforated Viscus Does the patient have perforated hollow organ (bowel)? A ® Did you check any boxes above? SIRS Does your patient have two or more of the following SIRS criteria? ® Temperature Is the patients temperature > 38°C (> 100.4°F) or < 36°C (< 96.8°F)? ® Heart RateIs the patients heart rate > 90 bpm? ® Respiratory Rate Is the patients respiratory rate > 20 breaths/min? ® WBC Count Is the patients WBC count > 12,000/mm 3 , < 4000/mm 3 , or are there > 10% immature neutrophi ls (left shift)? B ® Did you check two or more boxes above? ACUTE ORGAN DYSFUNCTION Does your patient have one or more of the following organ dysfunction criteria? ® Cardiovascular Does the patient have a systolic BP 90 mmHg or mean arterial pressure 70 mmHg (for at least 1 hour despite uid resuscitation) or require vasopressor support? ® RespiratoryDoes the patient have a PaO 2 /FiO 2 ratio 250, PEEP > 7.5 or require mechanical ventilation? ® Renal Does the patient have low urine output (eg, <0.5 mL/kg/hr for 1 hour despite adequate uid rescuscitation), increased creatinine (>50% increase from baseline) or require acute dialysis? ® HematologicDoes the patient have a low platelet count (< 100,000/mm 3 ) or PT/PTT > upper limit of normal? ® MetabolicDoes the patient have a low pH with high lactate (eg, pH < 7.30 and plasma lactate > upper limit of ...

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