Sepsis Unmasked: From Cells to Sirens (6.23.2025)-SSM Sepsis Protocol

SSM Sepsis Protocol

Pdf Summary

The document outlines a protocol for identifying and managing suspected sepsis or septic shock in adults within an emergency medical services (EMS) context. It highlights the importance of recognizing sepsis early since it is a rapidly progressing and potentially life-threatening condition due to systemic infection. The protocol is applicable to patients 18 years and older.

<h3>Key Signs and Symptoms of Sepsis</h3>
- Hyper/hypothermia
- Rash or excessive bruising
- Chills, myalgia
- Markedly decreased urine output
- Altered mental state
- Delayed capillary refill
- Elevated blood glucose (unless diabetic)

<h3>Differential Diagnoses</h3>
Conditions such as cardiogenic and hypovolemic shock, dehydration, hyperthyroidism, allergic reactions, and other infections should be considered and ruled out.

<h3>Suspected Sepsis Protocol</h3>
1. <strong>History Assessment</strong>: Includes checking age, presence of fever, previous infections, recent surgeries, and immunocompromised status.
2. <strong>H.A.T. Criteria</strong>:
   - <strong>Hypotension</strong>: SBP < 100 mmHg
   - <strong>Altered Mental Status</strong>: New onset
   - <strong>Tachypnea</strong>: Respiratory rate > 22/min or ETCO2 < 25 mmHg

<h3>Management Steps</h3>
- Use supplemental oxygen to maintain SpO2 at 94%.
- Monitor vital signs continuously.
- Administer fluid boluses (1000 mL Lactated Ringers preferred) if the patient is hypotensive, and adjust based on MAP (> 65) and SBP (> 100).
- If hypotension persists, consider medications like Rocephin, Maxipime, or vasopressors like Dopamine, Epinephrine, or Levophed to maintain blood pressure.
- Declare a "Sepsis Alert" during transportation to a facility with intensive care capabilities.
- Blood cultures and glucose levels should be obtained when possible.
- Immediate reassessment is necessary, especially if fluid boluses induce signs of fluid overload or resolve H.A.T criteria.

<h3>Additional Considerations</h3>
Blood glucose analysis and pregnancy assessment are also noted in the protocol. The document emphasizes continual reassessment and updating medical control as necessary.

Keywords

sepsis

septic shock

emergency medical services

H.A.T. criteria

hypotension

tachypnea

fluid boluses

vital signs

sepsis alert

differential diagnoses