2015 Trumbull Memorial Hospital Demo

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EMR EMT AEMT Paramedic Extended
Sepsis
Sepsis
Universal Patient Assessment
Oxygen
Titrate SpO2 to 94%
Cardiac Monitor
12-Lead ECG if applicable
If EMT or STEMI, transmit
Adult IV/IO
Consider Rapid Transport
Fluid Bolus
1000mL Normal Saline
repeat 2x
if lung sounds are clear.
Maintain SBP 90 mmHg
Sepsis/SIRS Screening Criteria
Any 2 of the following with possible infection:
 Temperature >38° C (100.3° F) or < 36° C (96.8° F)
 Pulse > 90 bpm
 Respirations > 20/min
 SBP < 90 mmHg or MAP < 65 mmHg
 Abnormal skin findings (purpura, dehydration)
If systolic BP < 80 mmHg despite 3 Liters of
fluid and you suspect septic shock:
Epinephrine Push-Dose Pressor
0.5-2 mL every 2-5 min
Still hypotensive
Notify receiving facility – sepsis alert
Report which criteria patient met
No Yes
Epi Push-Dose Conversion
Once mixed properly to 10
mcg/mL, this is the conversion:
Every 2 Minutes
 0.5mL q 2 min = 2.5 mcg/min
 1mL q 2 min = 5 mcg/min
 1.5mL q 2 min = 7.5 mcg/min
 2mL q 2 min = 10 mcg/min
Every 5 Minutes
 1mL q 5 min = 2 mcg/min
 1.5mL q 5 min = 3 mcg/min
 2mL q 5 min = 4 mcg/min