Sepsis, Severe Sepsis, Septic Shock

Severe Sepsis = SIRS + Organ Dysfunction + Infection

Septic Shock = Severe sepsis + hypotension OR lactate ≥4

SIRS = (2 or more)

• Temp >38.3 or <36
• HR >90
• RR >20
• WBC >12 or <4 or >10% bands
• Organ Dysfunction =
• SBP <90, MAP<65, or SBP drop >40
• Lactate >2
• Cr >2
• Bili >2
• Platelets <100K
• INR >1.5
• New onset resp failure (BiPAP or intubation)

Severe Sepsis Treatment (the BUNDLE):

• Serum lactate
• Blood culture x 2
• Antibiotics (FOLLOW THE PP for Abx!)
• 30 ml/kg for hypotension or lactate ≥4

Norepinephrine for persistent SBP <90