Clinical Pathway for Evaluation and Treatment of Suspected Sepsis in N/IICU Patients
Related Pathways
RN Notifies FLOC and Requests Bedside Huddle
RN, FLOC, +/- Attending or Fellow Huddle to Evaluate Signs/Symptoms Concerning for Sepsis:
- Vital Signs Trends
- Ins and Outs
- Labs within Last 24-48 Hours
- High-risk Conditions
- Congenital Heart Disease
Initial Workup:
- Obtain Sepsis Cart
- Cultures and Labs
- Ensure/Obtain IV/IO Access
- Antibiotics: Administer ASAP (goal within 60 minutes)
Initial Workup (if not already complete):
- Obtain Sepsis Cart
- Cultures and Labs
- Ensure/Obtain IV/IO Access
- Antibiotics: Administer ASAP (goal within 60 minutes)
- Rapid Fluid Resuscitation (NS) 10-20 mL/kg Bolus over 10-15 minutes
Does patient meet criteria for infection, sepsis or severe sepsis?
RN and FLOC reassess every 30-60 minutes
Ongoing Management of Septic Shock:
Posted: September 2018
Revised: February 2022
Authors: L. Srinivasan, MBBS; S. Gattoline, PharmD; K. Bordner, MPAS; S. Coggins, MD; J. Gerber, MD; K. Gibbs, MD; M. Harris, MD; M. Hayes, PharmD; T. Metjian, PharmD; D. Munson, MD; U. Nawab, MD; M. Padula, MD
Revised: February 2022
Authors: L. Srinivasan, MBBS; S. Gattoline, PharmD; K. Bordner, MPAS; S. Coggins, MD; J. Gerber, MD; K. Gibbs, MD; M. Harris, MD; M. Hayes, PharmD; T. Metjian, PharmD; D. Munson, MD; U. Nawab, MD; M. Padula, MD
Evidence
- American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock
- Hydrocortisone Dosing for Hypotension in Newborn Infants: Less Is More
- Cardiovascular Effects of Hydrocortisone in Preterm Infants With Pressor-Resistant Hypotension
- Blood pressure disorders in the neonate: hypotension and hypertension
- Determinants of blood pressure in infants admitted to neonatal intensive care units: a prospective multicenter study. Philadelphia Neonatal Blood Pressure Study Group
- Controversies in the diagnosis and management of hypotension in the newborn infant
- Late-onset Sepsis in Extremely Premature Infants: 2000-2011
- American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock
- Outcomes of Patients Undergoing Early Sepsis Resuscitation for Cryptic Shock Compared with Overt Shock
- Use of the Complete Blood Cell Count in Late-Onset Neonatal Sepsis