Sepsis Recognition
Sepsis is an out-of-control infection. It can be tricky to detect, and prehospital recognition relies heavily on the history of present illness (HPI). Indicators for increasing your index of suspicion include the following:
- Recent infection – check for antibiotics on medication lists.
- Abdominal distension and tenderness with positive rebound tenderness.
- Strong smell of urine – check catheter bag for discolored urine and ask about urinary tract infection (UTI) history.
- Recent illness – cough, cold/flu/covid symptoms.
- Fever/hypothermia – not all sepsis has a fever.
- Recent surgery.
- Rashes – i.e., cellulitis.
- Diabetes with skin lesions.
- Pressure sores and wounds.
- Immunocompromised – chemotherapy & AIDS.
- Animal bites, especially cat scratches.
Systemic Inflammatory Response Syndrome, or “SIRS” criteria: If you have an index of suspicion for sepsis, you should consider SIRS criteria. If any ONE of the following are positive, consider activation of a “sepsis alert” and transporting to appropriate receiving facility.
- Systolic BP <90 mmHg
- Heart Rate >90/min
- Respiratory rate >20/min
- GCS <15
- Temperature >100.40 F or <96.00 F
Note: Some EMS agencies have access to field lactate monitors. Local protocols will dictate usages and ranges for clinically significant elevation (usually above 4 mmol/L)
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Sepsis Recognition |
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Initials |
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