This is a new guideline from NICE on the detection and management of sepsis. None of this is likely to be new, but it is worth looking through. I think the main reason is, sadly, from a medico-legal point of view. I guess if we have not documented obs that have been clearly laid out, or ignored listed high-risk features, we will be at higher medico-legal risk. The good news is that there are quite easy to follow guidelines on what to do and what constitutes high- and medium-risk. Maybe worth printing out…
What assessment to carry out in patients with suspected sepsis:
- Heart Rate
- Respiratory Rate
- Level of consciousness
- Oxygen saturation (young people and adults)
- Capillary Refill (children under 12)
- Appearance (eg skin mottling / lip colour etc)
- Amount of urine passed in last 18 hrs
- Blood Pressure
- In all over 12s.
- 5 to 11-year-olds with suspected sepsis, if you have an appropriately sized cuff available and if its measurement doesn’t cause a delay in assessment or treatment.
- Under 5s if heart rate or capillary refill is abnormal.
High, moderate and low-risk features to watch out for:
There are too many to document here. NICE have created handy single page tables with the features. Maybe worth printing out and referring to if needed…
Information about specific features
Do not use fever alone, or its absence to rule out or rule in sepsis.