Sepsis Unmasked: From Cells to Sirens (6.24.2025)-SSM Sepsis Protocol

SSM Sepsis Protocol

Pdf Summary

The document outlines protocols for the identification and management of suspected sepsis or septic shock in adult patients. It specifies signs and symptoms, history, assessment, and immediate interventions to be taken by emergency medical services (EMS).

<strong>Signs and Symptoms:</strong> Key indicators include hyper/hypothermia, rash, excessive bruising, chills, muscle aches, decreased urine output, altered mentation, delayed capillary refill, and elevated blood glucose (unless diabetic).

<strong>Differential Diagnosis:</strong> Considerations include cardiogenic and hypovolemic shock, dehydration, hyperthyroidism, drug interactions, non-septic infections, allergic reactions, and toxicological emergencies.

<strong>Assessment and Intervention Steps:</strong>

1. <strong>Notification:</strong> Inform the destination hospital and consider contacting medical control.
   
2. <strong>History Considerations:</strong> Pay attention to age (more common in elderly and very young), fever duration, documented infections (e.g., UTI, pneumonia), recent surgeries, immunocompromised status, and use of prosthetic devices.

3. <strong>Monitoring:</strong> Use a cardiac monitor and administer oxygen to maintain SpO2 at 94%. Measure temperature and assess for infections.

4. <strong>H.A.T. Criteria for Diagnosis:</strong> Identify sepsis with hypotension (SBP < 100 mmHg), altered mental status, and tachypnea (RR > 22 or EtCO2 < 25 mmHg).

5. <strong>Treatment:</strong> If hypotensive, administer fluid boluses until SBP is > 100 mmHg (total dose: 1000 mL). Consider antibiotics like Rocephin or Maxipime, and initiate a sepsis alert for rapid hospital assessment.

6. <strong>Medication:</strong> In persistent hypotension, use dopamine, push dose epinephrine, or levophed to maintain adequate blood pressure.

The document emphasizes early recognition and aggressive treatment of sepsis to prevent progression to shock and death. It is crucial to continually reassess the patient, particularly monitoring for fluid overload or changes in H.A.T. criteria.

Keywords

sepsis

septic shock

emergency medical services

signs and symptoms

differential diagnosis

H.A.T. criteria

fluid bolus

antibiotics

dopamine

early recognition