Skip to content Skip to main menu Skip to utility menu

Know your sepsis six

September 13, 2022

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

Sepsis: Blood cultures

Blood cultures should be obtained prior to antibiotic administration. A clean peripheral swab must be obtained (must not be taken from existing lines/ new cannulae). Blood culture packs and bottles must be used and must be readily available in all clinical areas. ANTT (aseptic non touch technique) should be used during sampling to minimise the risk of contamination.

Note: Spare blood culture packs are now available in the resus vending machines across the Trust (City, ground floor by pharmacy, Sandwell, opposite pharmacy).