Adult Sepsis

Question 1

Adult Sepsis - Sepsis criteria

Answer 1

Suspected infection plus at least 2:
Temp < 38°C
Temp < 36°C
Heart rate > 90 bpm
Tachypnea > 20 bpm

Question 2

Adult Sepsis - Sepsis suspected and BP <90, MAP <65 or altered LOC 1st line treatment?

Answer 2

NS 500ml bolus prn to max of 2 L

Question 3

Adult Sepsis - Sepsis suspected and BP <90, MAP <65 or altered LOC 2nd line treatment?

Answer 3

Mandatory OLMC - Norepinephrine - Start at 0.1 mcg/kg/min to a maximum 0.3 mcg/kg/min
Or
CPAP / Airway management

Question 4

Adult Sepsis - Norepinephrine indications

Answer 4

Shock with hypotension refractory to fluid

Question 5

Adult Sepsis - Norepinephrine dose

Answer 5

Start at 0.1 mcg/kg/min to a max 0.3 mcg/kg/min

Titrate to effect, increasing dose as per infusion chart q 3 minutes

Question 6

Adult Sepsis - Norepinephrine EMS contraindications

Answer 6

Mesenteric or peripheral vascular thrombosis
Pregnancy
Profound hypoxia
Hypovolemia

Question 7

Adult Sepsis - Norepinephrine administration

Answer 7

Draw 4 mL off and discard from a 250 mL bag of D5W or Normal Saline
Add 4 mg (1mg/mL) norepinephrine for a concentration = 16 mcg/mL