2-25 SEPSIS

Purpose:

• Sepsis is a life-threatening medical emergency caused by your body’s overwhelming response to an infection. It causes extensive inflammation throughout your body that can lead to tissue damage, organ failure and even death.
• Goal of therapy is to recognize Sepsis early and perform interventions to assist with better patient outcomes.

Notes:

• Any patient requiring ACLS care should have an ALS intercept if logistically possible.

EMR/EMT - EMERGENCY MEDICAL RESPONDER

1. Provide routine medical care as indicated.
2. Administer oxygen if indicated.
3. Assist ventilations if RR < 8/min or > 35/min.
4. Assess for hypotension/ shock (HR >130, cap refill > 2 seconds) & follow Medical Hypotension / Shock protocol.
5. Call for ALS intercept

EMT- EMERGENCY MEDICAL TECHNICIAN PERFORM/CONFIRM ALL ABOVE INTERVENTIONS

1. Ensure ALS intercept is en route.
2. Transport as early as possible
3. Measure blood sugar if indicated, follow hypoglycemia protocol
4. Reassess VS & lung sounds often during transport
5. Apply EtCO2
6. Recognize the Presence of Systemic Inflammatory Response Syndrome (SIRS):
   1. Heart rate > 90
   2. Respiratory rate > 20
   3. Temp > 100.4 F or < 96.8 F
7. Apply ECG monitor & run strip (if trained, if time allows, and after all other interventions are completed).
8. Perform 12-lead ECG (if trained) as indicated.
9. Contact Medical Control.

AEMT – ADVANCED EMERGENCY MEDICINE TECH PERFORM/CONFIRM ALL ABOVE INTERVENTIONS

1. Initiate IV (Do not delay transport).
2. Administer NS fluid bolus, TKO (Up to 1,000mL).
3. Report Lung Sounds.

INTERMEDIATE/PARAMEDIC PERFORM/CONFIRM ALL ABOVE INTERVENTIONS

1. Attach cardiac monitor if not already done,
2. Administer NS fluid bolus up to a total of 1000 mL -IF-
   1. Symptomatic, no dysrhythmia & lungs are clear
3. Reassess VS, lung sounds & rhythm frequently
4. Consider Septic Shock when the following criteria are met:
   1. Presence of Systemic Inflammatory Response Syndrome (SIRS):
      1. Heart rate > 90
      2. Respiratory rate > 20
      3. Temp > 100.4 F or < 96.8 F
   2. Suspected infection
   3. Signs of hypoperfusion
      1. Including EtCO2 <26 on two consecutive readings 5 minutes apart
5. If the criteria for Septic Shock are met, consider alerting receiving facility of the concern for aseptic patient. CONTACT MEDICAL CONTROL
6. May administer additional NS fluid bolus, as directed, after a total of 500 mL -IF
   1. Symptomatic, no dysrhythmia & lungs are clear.
7. May administer Push Dose Epinephrine to maintain blood pressure / tissue perfusion.
   1. Push Dose Epi 5-20 mcg IV q5 PRN
   2. Epi Infusion 1-20mcg/min
8. Consistent Hypotension consider 2nd liter of NS if not previously administered
9. Confirm all above interventions were completed