Sepsis ⚠️

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🚨 Quick Recognition

  • qSOFA ≥2 or NEWS ≥5 + suspected infection = sepsis risk
  • Septic shock = sepsis + hypotension + lactate >2 despite fluids
  • Key signs: fever, confusion, mottled skin, cold extremities

👩‍⚕️ Carer/Nurse Concerns

  • Common triggers: "Patient not themselves", "worse than usual", "not eating/drinking"
  • Red flags: "They look different", "very sleepy", "not responding", "cold to touch"
  • Always take seriously: Trust clinical intuition, even if vitals seem "okay"

📞 Immediate Actions

  • Request vitals + NEWS/qSOFA score
  • Ask: "Is patient deteriorating? Any infection focus?"
  • Prepare: IV access, fluids, septic screen

🔍 Infection Focus

  • History: Cough, dysuria, confusion, pain, recent surgery, devices (IDC, cannulas, CVLs)
  • Examination: Chest, abdomen, wounds, lines, joints, neuro signs
  • Neutropenic patients: atypical presentations, consider fungal/atypical infections

🧪 Essential Workup

  • Septic screen: Blood cultures, urine dip, CXR, sputum/wound/line swabs
  • Bloods: FBC, CRP, U&Es, lactate, coag, glucose
  • ABG/VBG for lactate and acidosis

💊 BUFALO (Sepsis 6 - Within 1 Hour)

  • B - Blood cultures (before antibiotics)
  • U - Urine output (hourly, consider catheter)
  • F - Fluids (500ml bolus, reassess)
  • A - Antibiotics (empirical IV within 1 hour)
  • L - Lactate (serum level)
  • O - Oxygen (high-flow if needed)
  • → ALWAYS inform MROC/senior - escalate if shocked/deteriorating

Advanced Sepsis Scoring Tool

qSOFA and SIRS criteria assessment

Vital Signs & Lab Values

Assessment Results

qSOFA Score0 / 3
✅Low risk – unlikely sepsis
SIRS Criteria0 / 4
✅SIRS unlikely – monitor clinical status

⚠️ WCC not entered — full SIRS score may be incomplete

Note Template

Ready-to-use clinical note structure

🕒 20 / 11 / 2025 — 23:25

ATRP re: suspected sepsis
Patient: [age] [sex]
Admission Dx: [reason for admission]
PMHx: [immunosuppression, chronic illness]

🧾 Hx:
• Source of infection: [pneumonia, UTI, line, skin]
• Symptoms: fever, chills, rigors, confusion
• Duration and progression
• Recent antibiotics or hospitalisation

🩺 Exam:
• Vitals: HR __ BP __ Temp __ RR __ SpO₂ __
• Mental status: alert / confused / drowsy
• Signs of infection: erythema, wounds, catheter sites
• Capillary refill, urine output

📋 Impression:
Likely sepsis ± septic shock

📌 Plan:
• Sepsis 6 within 1 hour:
  - Oxygen to maintain sats > 94%
  - Blood cultures and other relevant cultures
  - IV antibiotics (broad spectrum)
  - IV fluids (crystalloids)
  - Check lactate and send blood tests
  - Monitor urine output
• Source control if indicated
• Escalate care if deteriorating

👤 [Your Name], [Role]
IMC: _______
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