Sepsis Kills. As a healthcare provider: Know the facts and save lives!

1. SEPSIS
Sepsis Is A Medical Emergency!
!
Jessica Dela Rosa, MBA, BSN, RN.

2. SEPSIS. NO CURE, BUT A LOT OF OPPORTUNITY
2
RAPID IDENTIFICATION
EARLY IMPLENTATION
STOP THE SEPSIS CASCADE
SAVE A LIFE!
!
Studies show most effective method to improving survival
and overall outcomes for patients affected.
Organized. Rapid.
!
CODE SEPSIS
BEST PRACTICE
In the rapid identification and treatment of sepsis

3. CoreMeasure2015
3
Exclusions
•Directive for comfort
care within 3 hours of
severe sepsis or within 6
hours of septic shock.
•Length of Stay > 120
days
•Transfer from an ACUTE
care facility.
•Severe Sepsis expires
within 3 hours of
presentation or 6 hours
for septic shock.
•Administrative
Contraindications**
!
** Bundle not
implemented? Why?
Only option:
- Patient refused blood
draw, fluid administration,
or antibiotics.
!
!
*HCA initiative is 1 Hour Goal
3*
Severe
Sepsis
Septic
Shock
Severe
Sepsis
Septic
Shock
*
* Must be documented by
MD.

4. CODE
SEPSIS
4
BEST PRACTICE
IMPROVE OUTCOMES
CORE MEASURE
QUALITY CARE
Patient

5. Sepsis is on the rise
-Aging population
-Increased longevity of people with chronic illness
-Increase in antibiotic resistanceWHY?
WHAT?
REFRESH MY MEMORY….
5
SIRS Criteria:!
Temp greater than (>) or equal to 100.4
or less than (<) 96.8!
HR > 90!
RR > 20!
WBC > 12thou < 4thou!
Bands > 10%

6. SEPSIS
CASCADE
6

7. What do we see on the surface?
7
Screening Tool
Lactic Acid
Pathophysiology

8. LACTIC ACID
9
What does it mean?
!
Aerobic Metabolism
vs.
Anaerobic Metabolism
!
!
Energy !
!
!
!
POC Lactate : Instant Result

9. 1
2
3
GO!
10

10. Rapid Response Team (RRT)
11Sepsis wont wait! Neither will we!!

11. Physician Notification
14
❑ Report:
- Lactate Level / vital signs
- WBC Count / Bands if any
- Blood cultures obtained
!
❑ Review antibiotics administered or
none ordered.
!
❑ Discuss fluid bolus, (*this patient has
crackles mid-way up; warrants discussing
with MD an order to bolus fluid as called for
by SSC guidelines)
!
❑ Sepsis Order Set Implement and/or ICU
transfer.
✓ Measure Lactate Level
✓ Obtain blood cultures
✓ Administer broad spectrum
antibiotics
✓ Administer 30ml/kg crystalloid
for hypotension or lactate
greater than or equal to
4mmol/L.

12. WHY SEPSIS BUNDLE ORDER SET?
The Sepsis Bundle Order Set:
!
✓MONITORS LACTIC ACID -
TRENDING
• Biomarker of anaerobic metabolism
• CORE MEASURE: indicates lactate rechecks
!
✓ FLUID BOLUSES
• guides fluid management
• restores aerobic metabolism and
• perfusion pressure.
• CORE MEASURE: Fluid resuscitation
!
✓ APPROPRIATE EMPIRIC ANTIBIOTICS
• guides appropriate selection
!
✓ ID MD 15Supports sepsis Core Measure criteria to be MET!