1. Septic Pathway UNIVERSITY HOSPITAL COVENTRY AND WARWICKSHIRE Dr Gregg Eloundou

2. Sepsis Screening Toll MEWS of >4 or if there is a suspicion of infection

3. - T emp 38.5 - Respiratory Rate > 20/mins - Heart Rate >90bpm - WWC >12 or <4 - Acutely altered mental state - Hyperglycaemia in the absence of diabetes - Systolic BP 40mmHg from the “normal If Yes, Patient has Signs and Symptoms of infection (SSI) ARE ANY TWO OF THE FOLLOWING SSI CRITERIA PRESENT?

4. DOES THE PATIENT HAVE A HISTORY OR SIGNS SUGGESTIVE OF NEW INFECTION? For Example Couph/sputum/chest pain Chills with rigor Abdo pain/distension/diarrhoea Headache with neck stiffness Line infection Cellulitis/wound infection Septic arthritis Possible UTI Endocarditis CRRS infection alert If yes, patient has Sepsis – contact F1/F2/SHO/Registrar for Review

5. If yes, Make a SBAR call – START SEPSIS SIX and COMPLETE in 1 hour 1.Oxygen 2.Blood cultures 3.IV Antibiotics 4.IV Fluids 5.Measure Lactate (Arterial Blood Gas) 6.Accurate Urine Output Measurement Place Sepsis Sticker in Medical Notes

6. On a Practical Level Call for Help – Consultant Obstetrician and Anaesthesis, Senior Midwife, Microbiologist, porter Admit into HDU Start MEWS or HDU chart IV antibiotics 6hourly blood Hourly Reviews

7. Group work Design Septic pathway for your health Centres Taking local parameters into consideration