2015 Trumbull Memorial Hospital Demo

Sepsis Sepsis

Universal Patient Assessment

Oxygen Titrate SpO2 to 94%

Sepsis/SIRS Screening Criteria Any 2 of the following with possible infection:  Temperature >38° C (100.3° F) or < 36° C (96.8° F)  Pulse > 90 bpm  Respirations > 20/min  SBP < 90 mmHg or MAP < 65 mmHg  Abnormal skin findings (purpura, dehydration)

Yes

No

Notify receiving facility – sepsis alert Report which criteria patient met

Cardiac Monitor 12-Lead ECG if applicable If EMT or STEMI, transmit

Consider Rapid Transport

Epi Push-Dose Conversion Once mixed properly to 10 mcg/mL, this is the conversion: Every 2 Minutes  0.5mL q 2 min = 2.5 mcg/min  1mL q 2 min = 5 mcg/min  1.5mL q 2 min = 7.5 mcg/min  2mL q 2 min = 10 mcg/min Every 5 Minutes  1mL q 5 min = 2 mcg/min  1.5mL q 5 min = 3 mcg/min  2mL q 5 min = 4 mcg/min

Adult IV/IO

Fluid Bolus 1000mL Normal Saline repeat 2x if lung sounds are clear. Maintain SBP 90 mmHg

Still hypotensive

If systolic BP < 80 mmHg despite 3 Liters of fluid and you suspect septic shock: Epinephrine Push-Dose Pressor 0.5-2 mL every 2-5 min

54

EMR

EMT

AEMT

Paramedic

Extended