Sepsis

Understanding the progression, recognition, and management of sepsis.

Sepsis Scenario Challenge

Test your clinical judgment with these sepsis cases.

"An 82-year-old female is brought from a nursing home with a productive cough, fever of 102.8°F, and confusion. Her family states she has been less responsive today."

Vitals & Key Findings

BP: 90/50 mmHg, HR: 120 bpm, RR: 28, SpO2: 91%

What is the nurse's priority action?

Stages of Sepsis

Understanding the clinical definitions and criteria (Sepsis-3).

Sepsis

A life-threatening organ dysfunction caused by a dysregulated host response to infection. Diagnosed with a SOFA score increase of ≥2 points.

Key Signs: Suspected or confirmed infection PLUS signs like altered mental status, tachypnea (RR ≥ 22), hypotension (SBP ≤ 100 mmHg), fever or hypothermia.

Septic Shock

A subset of sepsis with profound circulatory, cellular, and metabolic abnormalities, associated with a greater risk of mortality than sepsis alone.

Criteria: Persistent hypotension requiring vasopressors to maintain a Mean Arterial Pressure (MAP) of ≥65 mmHg AND a serum lactate level >2 mmol/L despite adequate fluid resuscitation.

Standard Treatment Bundles

Key time-sensitive interventions from the Surviving Sepsis Campaign.

Within 1 Hour ("Hour-1 Bundle")

  • Measure lactate level (and remeasure if initial lactate is >2 mmol/L).
  • Obtain blood cultures before administering antibiotics.
  • Administer broad-spectrum antibiotics.
  • Begin rapid administration of 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L.
  • Apply vasopressors if hypotensive during or after fluid resuscitation to maintain a MAP ≥65 mmHg.

Ongoing Management

  • Continuous monitoring of vital signs and hemodynamic status.
  • Re-assessment of volume status and tissue perfusion.
  • Source control: Identify and manage the source of infection (e.g., drainage of an abscess, removal of infected device).
  • Supportive care: May include mechanical ventilation, renal replacement therapy, or glucose control.