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Suspect sepsis
If you, a relative, or a patient feels "severely sick", "that something is wrong", or "are not yourself", and shows any of the following symptoms, you should suspect sepsis:
  • Weakness
  • Loss of appetite
  • Fever and chills
  • Thirst
  • Signs of worsening organ function such as:
  • Difficult or rapid breathing
  • Rapid heart rate
  • Low blood pressure
  • Low urine output

  • If any of these symptoms are present and the person has a suspected or diagnosed infection (e.g. pneumonia, abdominal infection, urinary tract infection, or wound infection), sepsis is the most common cause.


How intensive care providers diagnose sepsis
Sepsis is diagnosed if the following criteria are present: Infection (documented or suspected) and some of the following…

General variables
  • Fever (core temperature > 38.3°C/100.9°F)
  • Hypothermia (core temperature < 36°C/96.8°F)
  • Heart rate >90 min-1 or >2 SD above the normal value for age
  • Rapid breathing
  • Altered mental state
  • Significant edema (accumulation of fluid) or positive fluid balance (>20 mL/kg over 24 hrs)
  • Hyperglycemia (blood sugar >120 mg/dL or 7.7 mmol/L) in the absence of diabetes Inflammatory variables
  • Leukocytosis (high white blood cell count > 12,000 µL-1)
  • Leukopenia (low white blood cell count > 4000 µL-1)
  • Normal white blood cell count with > 10% immature forms
  • Plasma C-reactive protein > 2 SD above the normal value
  • Plasma procalcitonin > 2 SD above the normal value
  • Hemodynamic (blood circulation) variables
  • Arterial hypotension (SBP < 90 mm Hg, MAP < >70, or an SBP decrease > 40 mm
  • Hg in adults or > 2 SD below normal for age)
  • SvO2 <70%
  • Cardiac index > 3.5 L/min per square meter
  • Organ dysfunction variables
  • Arterial hypoxemia (blood oxygen deficiency) (PaO2/FIO2 <300)
  • Acute oliguria (low urine output) (urine output <0.5 mL×kg-1×hr-1 or 45 mmol/L for at least 2 hrs)
  • Creatinine increase > 0.5 mg/dL
  • Coagulation abnormalities (INR > 1.5 or aPTT > 60 secs)
  • Ileus (absent bowel sounds)
  • Thrombocytopenia (low blood platelet count) (platelet count < 100,000 µL-1)
  • Hyperbilirubinemia (plasma total bilirubin > 4 mg/dL or 70 mmol/L)


Tissue perfusion variables
  • Hyperlactataemia (low pH) (>1 mmol/L)
  • Decreased capillary refill or mottling
  • Please keep in mind: Laboratory signs are unspecific and common. Normal white blood count and lack of fever do not rule out sepsis. Hypothermia and leucopenia (low white blood cell count) are signs of unfavorable prognosis. Some national and international guidelines recommend procalcitonin to guide antibiotic therapy and to confirm the diagnosis of sepsis.


Or as Carl Flatley, founder of the Sepsis Alliance put it in this mnemonic:
"U C the bugs running home"
U = low urine output
C = chills, confusion, consciousness
T = temperature above 100°F/38°C or below 97°F/36°C
B = blood pressure, high or low
H = heart rate over 90 per minute

The International Sepsis Guideline
The International Sepsis Guidelines were developed between 2004 and 2008. The updated version, Feb. 2013 is available at the following link. These guidelines give you, as a healthcare professional, the knowledge you need to act when you suspect sepsis.

Download ... SSC-Guidelines.pdf
FAQs
Over the past year we've been collecting the questions we receive most frequently about sepsis. Please share this information with your friends and family. Don’t see your question on the list? Get in touch with us, and we’ll do our best to help.
Sepsis Facts
Sepsis is common and often deadly. It remains the primary cause of death from infection, despite advances in modern medicine like vaccines, antibiotics, and intensive care.
What is sepsis
Pat had a pneumococcus sepsis because he lost his spleen after a car accident as a teenager. He experienced multiple organ failure, followed by critical illness polyneuropathy.
How to prevent sepsis
Sepsis is always caused by an infection, most often by bacteria, but sometimes by fungi or protozoa (such as malaria). That means that preventing infection is one of the best ways to prevent sepsis.
Suspect sepsis
If you, a relative, or a patient feels "severely sick", "that something is wrong", or "are not yourself", and shows any of the following symptoms, you should suspect sepsis: