Back to basics: Spotting the red flags and screening for Sepsis

March 29, 2022

Sepsis (also known as blood poisoning) is the immune system’s overreaction to an infection or injury. Normally our immune system fights infection – but sometimes, for reasons not yet fully understood, it attacks our body’s own organs and tissues. If not treated immediately, sepsis can result in organ failure and death. Yet with early diagnosis, it can be treated with antibiotics.

Spotting sepsis in patients can at times be difficult due to the symptoms being similar to many other conditions, but following a few simple screening rules can significantly improve detection and treatment times.

Red flag criteria indicating high risk of deterioration

• Objective evidence of new or altered mental state
• Systolic BP ≤ 90 mmHg (or drop of > 40 from normal)
• Heart rate ≥ 130 per minute
• Respiratory rate ≥ 25 per minute
• Needs O2 to keep SpO2 ≥ 92% (88% in COPD)
• Non-blanching rash/mottled/ashen/cyanotic
• Lactate ≥ 2 mmol/l
• Recent chemotherapy
• Not passed Urine in 18 hours (<0.5ml/kg/hr if catheterised)

Once sepsis has been detected, applying the sepsis six care bundle within 60 minutes can double your patients chance of survival:

• Give high flow oxygen
• Take blood cultures
• Give IV antibiotics
• Give a fluid challenge
• Measure lactate
• Measure urine output

Colleagues who are unsure of the sepsis screening processes are encouraged to speak to their ward matrons or contact the deteriorating patients and resus team on ext. 5908.