Sepsis, N/IICU — Initial Sepsis Huddle — Clinical Pathway: ICU and Inpatient

Suspected Sepsis Clinical Pathway — N/IICU

Initial Sepsis Huddle

Congenital heart disease can present similar to sepsis. For neonates under 2 weeks of age with perfusion abnormality and hypotension, consider evaluating for a ductal dependent lesion and initiating PGE1 infusion.

Communication
  • Notify:
    • FLOC
    • Fellow or attending
    • Charge nurse
  • FLOC documents results of huddle in EMR progress note:
    • Smart Text: N/IICU Sepsis Event Note
    • Dotphrase: .nicusepsis
Parameters to Assess
  • Changes in:
    • Temperature
    • Heart rate
    • Respiratory status
    • Perfusion, including urine output
    • Blood pressure
    • Mental status
    • Feeding tolerance
Frequency of Assessment
  • Every 30-60 min as determined by team at time of sepsis huddle
  • Discuss with the FLOC, fellow, or attending when to space out these assessments

Heart Rate and MAP

Evaluate prior baseline heart rate, as well as trend during 24 hours before symptom manifestation.

Age Heart Rate MAP
0 to 7 days 100-180 > 35*
7-30 days 100-160 > 40
31 days to < 1 yr 100-160 > 45
1 yr to < 2 yr 90-160 > 50

*Preterm Infants (< 37 Weeks Gestational Age)

  • First 72 hrs of life: MAP should be ≥ infant’s gestational age
  • After 72 hrs: MAP should be ≥ 30