1. United States Statistics on Sepsis
Sepsis Shout Out
Objectives:
Recognize early indicators of sepsis
Differentiate between SIRS, Sepsis and Severe Sepsis
Improve patient outcomes
Decrease morbidity and mortality rates
Decrease length of stay
Decrease costs
United States Statistics on Sepsis
750,000 cases per year
200,000 annual fatalities
11% to 27% of ICU admissions have severe sepsis
{AHRQ 2008 Data}

2. Think Sepsis
Infection – suspected or confirmed and 2 or more SIRS criteria below:
Temp < 96.8 F or > F
RR > 20
HR > 90
WBC > 12,000 or < 4,000
Neutrophil Bands > 10%
If Yes – Call Physician Immediately
Early Recognition of the Signs and Symptoms along with Treatment are the Key.
(Surviving Sepsis Campaign 2012)

3. Etiology of Progression
SIRS
Hypothermia / Fever
Tachypnea
Tachycardia
WBC increased or decreased
2 or more SIRS criteria
Evidence of Infection such as
Positive Blood Cultures
Pneumonia on CXR
Other Radiologic or Laboratory Results
Sepsis
Sepsis with End-Organ Dysfunction
Serum Lactate > 4
Altered Mental State
Refractory Hypotension that does not respond to treatment
Poor perfusion leading to all organ system shut down
Severe Sepsis

4. Care Bundles TO BE COMPLETED WITHIN 3 HOURS: Measure lactate level
2) Obtain blood cultures prior to administration of antibiotics
3) Administer broad spectrum antibiotics
4) Administer 30 ml/kg crystalloid for hypotension or lactate ≥4mmol/L
TO BE COMPLETED WITHIN 6 HOURS:
5) Apply vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a mean arterial pressure (MAP) ≥65 mm Hg
6) In the event of persistent arterial hypotension despite volume resuscitation (septic shock) or initial lactate ≥4 mmol/L (36 mg/dL):
--Measure central venous pressure (CVP)*
--Measure central venous oxygen saturation (ScvO2)*
7) Remeasure lactate if initial lactate was elevated*
*Targets for quantitative resuscitation included in the guidelines are CVP of ≥8 mm Hg; ScvO2 of ≥70%, and normalization of lactate.