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Sepsis, Suspected — Recommended Laboratory Studies — Clinical Pathway: CICU/CCU

Suspected Sepsis Clinical Pathway — CICU/CCU

Recommended Laboratory Studies

Blood
  • POC glucose
  • Venous super gas, lactate level
  • Blood culture (obtain before antibiotics are given unless doing so significantly delays antibiotic administration)
  • CBC with differential, if not sent in last 24 hours
  • Procalcitonin, if not sent in last 24 hours
  • CRP
  • Basic metabolic panel, LFTs, amylase, lipase
  • INR, PT, PTT, fibrinogen
  • Type and screen
  • Consider random cortisol level*, if in the setting of refractory or septic shock.
Urine
  • UA
  • Urine culture if symptoms of UTI and UA suggestive of infection
  • Urine HCG for females > 12 years, if not sent on admission
X-ray Consider chest and/or abdominal radiograph
Viral Studies as Clinically Indicated
  • URI symptoms — consider respiratory viral testing
  • June-October — consider enteroviral PCR blood and CSF in patients ≤ 56 days
CSF Studies as Clinically Indicated Discuss with CICU Attending before LP
Site, Skin, Wound Cultures Discuss utility with CICU and/or CT Surgical Attendings

*Send If Risk of Adrenal Insufficiency

  • Purpura fulminans
  • Congenital adrenal hyperplasia
  • Prolonged steroid treatment (> 2 weeks)
  • Catecholamine resistant shock

 

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