BASIC EMS Sepsis Notes

Sepsis Criteria
●​ Temperature >100.4ºF or <96.8ºF
●​ Pulse >90bpm
●​ Respirations >20/min
○​ Count for at least 30 seconds

Organ Dysfunction
●​ MAP <65mmHg
●​ SBP <90mmHg
●​ SBP decrease of 40mmHg from baseline
●​ Indicates severe sepsis

Comorbidities
●​ COPD worst with sepsis
●​ End-stage renal disease
●​ Sepsis becomes more morbid with pre-existing conditions

Antibiotics
●​ Give for sepsis even if patient is already taking antibiotics
○​ Most people are non-compliant
○​ If showing sepsis symptoms, it means patient is not using their antibiotics
○​ If sepsis symptoms, follow protocol
●​ Culture sensitivity decreases after antibiotic administration
○​ Blood cultures always before antibiotics
●​ Mortality increases by 10% for each hour without antibiotics
●​ Ceftriaxone safe for penicillin allergy

Drawing Cultures
●​ Blue/green (aerobic) first
●​ Purple/orange (anaerobic) last


Reassessment
●​ Endotoxic shock response shown by hypotension
●​ From gram- bacteria death
○​ UTIs usually gram-
●​ Check bp after antibiotic administration

Non-bacterial Pathogens
●​ Virus can lead to bacterial infections
○​ Still give antibiotics if viral
●​ Fungal pathogens mostly in immunocompromised
●​ Protozoal pathogens, like malaria
○​ Question about foreign travel