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Nice | Detection and management of sepsis

4th August 2016 by Louise Hudman

Nice | Detection and management of sepsis

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:

  • Temperature
  • 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…

  • Assessment in the over 12s.
  • Assessment in 5 to 12-year-olds.
  • Assessment in the under 5s.

Information about specific features

Fever

Do not use fever alone, or its absence to rule out or rule in sepsis.

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