Important: Therapy
If NEWS ≥ 5 or clinical concern of systemic infection or neutropenia suspected refer to ED Sepsis Screening tool [intranet only].
Life-threatening organ dysfunction caused by a dysregulated host response to infection.
For clinical use and measurement, organ dysfunction can be represented by an increase in the SOFA score of 2 points or more. These patients have SEPSIS and an in-hospital mortality >10%.
- Take blood (2 sets - 20mL per set) and urine cultures before starting treatment, plus swabs from any other focus of infection, e.g. sputum, wound etc
- Give antibiotics as soon as possible, within 1 hour of diagnosis of sepsis
- Prompt diagnosis is vital to allow early rationalisation of treatment.
- The most common causes of sepsis are urinary or respiratory sources which should be treated according to the relevant sections in this guideline (oral co-trimoxazole will cover both in cases where no IV is required).
- Seek advice from Medical Microbiology or Infection Unit.
- Sepsis may be masked in immunosuppression, the elderly and in the presence of anti-inflammatory drugs and beta-blockers.
- Consider immune deficiency and testing for HIV.