PLACE LABEL HERE
SEPSIS ORDERS
Emergency Department
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
DIAGNOSIS / CRITERIA / RECOMMENDATIONS FOR CRITERIAFever /
- Temperature > 38.3°C (101°F)
- If infection is suspected, evaluate SIRs Criteria for Sepsis diagnosis
Sepsis
(Suspected infection, 1-2 SIRs Criteria w/o organ dysfunction) / Source of actual/suspected infection: ______
SIRs Criteria:
- Temperature > 38.3°C (101°F) or < 36°C (96.8°F)
- Heart Rate 90 bpm (tachycardia)
- Resp Rate 20 bpm (tachypnea)or pCO2 < 32 mmHg
- WBC > 12,000 or < 4,000 or > 10% bands
- Initial Lactate level
- Blood cultures prior to antibiotic start
- Appropriate antibiotic selection
Severe Sepsis
(Suspected infection, ≥ 2 SIRs Criteria w/ any evidence of acute organ dysfunction) / Source of actual/suspected infection: ______
SIRs Criteria:
- Temperature > 38.3°C (101°F) or < 36°C (96.8°F)
- Heart Rate 90 bpm (tachycardia)
- Resp Rate 20 bpm (tachypnea) or pCO2 < 32 mmHg
- WBC > 12,000 or < 4,000 or > 10% bands
- SBP < 90, MAP < 65, or a SBP decrease of > 40 points
- Creatinine > 2.0 or urine output < 0.5 ml/kg/hr for 2 hrs
- Bilirubin > 2 mg/dL
- Platelet count < 100,000
- INR > 1.5 or PTT > 60 sec
- Lactate > 2 mmol/L
- Repeat Lactate if initial is 2 mmol/L
- Blood cultures prior to antibiotic start
- Appropriate IV antibiotic selection started within 3 hrs of severe sepsis
- Fluid Resuscitation at 30 ml/kg of crystalloidif hypotensive or suspected hypovolemia and repeat focused clinical exam 30 min after initiation (including vitals, cardiopulmonary, capillary refills, peripheral pulses, and skin assessment)
Septic Shock
(Suspected infection, ≥ 2 SIRs Criteria w/ any evidence of acute organ dysfunctionand persistent tissue hypo perfusion after crystalloid fluid administrationorinitial lactate level ≥ 4 mmol/L) / Source of actual/suspected infection: ______
SIRs Criteria:
- Temperature > 38.3°C (101°F) or < 36°C (96.8°F)
- Heart Rate > 90 bpm (tachycardia)
- Resp Rate 20 bpm (tachypnea) or pCO2 32 mmHg
- WBC > 12,000 or < 4,000 or > 10% bands
- SBP < 90, MAP < 65, or a SBP decrease of > 40 points
- Creatinine > 2.0 or urine output < 0.5 ml/kg/hr for 2 hrs
- Bilirubin > 2 mg/dL
- Platelet count < 100,000
- INR > 1.5 or PTT > 60 sec
- Lactate ≥ 4 mmol/L
- For ED patients needing a critical care bed initiate ED Sepsis Alert
- Blood cultures prior to antibiotic start
- Appropriate IV antibiotic selection started within 3 hrs of severe sepsis
- CVC in superior vena cava
- CVP and ScvO2 monitoring within 6 hrs
- Required, if not already done: Fluid Resuscitation at 30 ml/kg of crystalloid if hypotensive or suspected hypovolemia and repeat focused clinical exam 30 min after initiation (including vitals, cardiopulmonary, capillary refills, peripheral pulses, and skin assessment)
Copy to pharmacyOrder writer’s initials ______
*3-39412*FORM 3-39412 REV.08/2017 Page 1 of 4
PLACE LABEL HERE
SEPSIS ORDERS
Emergency Department
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
EMERGENCY DEPARTMENT ORDERS:
- STAT Diagnostics:
CBC w/ Diff Chem 7CMPLipase ABG PT/INR and PTT DIC ProfileRapid Strep
Serum Lactate (Repeat in 4 hrs if > 2) Magnesium level Urinalysis Urine culture Monospot
GC/Chlam Probe Influenza Panel Quantitative hCG (Menstruating female ≥ 12 years of age)
Sputum culture and gram stain (Required if suspected pneumonia or intubated)
Blood cultures x 2, 10-15 min apart or 1 peripheral and 1 culture from each vascular access site (Culture prior to antibiotic therapy)
EKG Reason: ______Read by: ______
CXR Portable PA/LatReason: ______
Portable KUBReason: ______
Abdomen Flat/UprightReason: ______
Sinus Series Complete Reason: ______
Soft Tissue NeckReason: ______
CT Head w/or w/o contrast Reason: ______
CT Chest w/or w/o contrastReason: ______
CT Abd/Pelvis w/or w/o contrastReason: ______
CT Renal Stone w/o contrastReason: ______
- Vital signsq 1 hr q 4 hr
- Pulse Oximetry with vital signs. Keep SATs greater than 90%
- Cardiac Monitoring
- Notify physician for SBP < 90, MAP < 65, or > 40 point decrease in last recorded SBP considered normal
- Insert INT
- Glucose Finger Stick STAT x 1, Notify physician if > 180
- Procedure Set Up- Give Consent to Patient/Family:CVCPlacement Lumbar Puncture Moderate Sedation
- Urinary catheter to bedside bag for: ______, discontinue per Foley Standing Orders (#31620)
- Obtain and document actual weight (Required prior to ordering medications)
MEDICATIONS:
- Nebulizer:
Albuterol 2.5 mg / ipratropium 0.5 mg (Duoneb) inhalation STAT x 1 dose
Xopenex 0.63 mg 1.25 mg inhalation STAT x 1 dose
Albuterol 2.5 mg 5 mg inhalation STAT x 1 dose May repeat x 3 doses per Resp Care Protocol (7504-10-03-02)
Racemic EPI 2.25% 0.5 ml inhalation STAT x 1 dose
- IV Fluid Resuscitation:
Normal Saline1 liter IV bolus over 30 min x ____ liters
Lactated Ringers 1 liter IV bolus over 30 min x ____ liters
Severe Sepsis (Recommended): Normal Saline 30 ml/kg IV bolus over 30-60 min
May hang multiple bags wide open or use pressure bags, if needed. Recheck vitals 30 min after infusion completion and notify physician if SBP < 90, MAP < 65, or > 40 point decrease in last recorded SBP considered normal.
Septic Shock (Required): Normal Saline 30 ml/kg IV bolus over 30-60 min
May hang multiple bags wide open or use pressure bags, if needed. Recheck vitals 30 min after infusion completion and notify physician if SBP < 90, MAP < 65, or > 40 point decrease in last recorded SBP considered normal.
- VASOPRESSORS (TITRATE TO MAP ≥65 mmHg):
Levophed (NORepinephrine) infusion, dosing range: 0.5 - 30 mcg/min
- Change rate: 2-10 mcg/min q 2 min to MAP ≥ 65 or SBP > 90 mmHg
ADD Pitressin (vasopressin) infusion at 0.03 units/min (18 ml/hr) dosing range: 0.02-0.04 units/min
- Change rate: 0.01 units/min q 15 min to maintain MAP ≥ 65 mmHgfor persistent hypotension
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
- Antibiotic: (Select based on known/suspected source of infection)
- For septic patients, administer antibiotic after blood culture specimen collection
Community Acquired Pneumonia without pseudomonal risk / Rocephin (ceftriaxone) 1 gm IV STAT x 1 dose
AND
Zithromax (azithromycin) 500 mg IV STAT x 1 dose / Avelox (moxifloxacin) 400 mg
IVor po** STAT x 1 dose
**IV only if severe sepsis or septic shockdiagnosis.
AND ADD
Rocephin (ceftriaxone) 1 gm IV STAT x 1 dosefor Severe Sepsis/Septic Shock
Community Acquired Pneumonia with pseudomonal risk
Check an indication:
Immunocompromised
Severe COPD with frequent antibiotic or systemic steroid use
Structural lung disease (e.g. Bronchiectasis; Cystic Fibrosis) / Zosyn (piperacillin/tazobactam) 4.5 gm IV STAT x 1 dose
AND
Cipro (ciprofloxacin) 400 mg IV STAT x 1 dose / Documented Penicillin Allergy
Merrem (meropenem) 1 gm IV STAT x 1 dose
AND
Cipro (ciprofloxacin) 400 mg IV STAT x 1 dose
Aspiration Pneumonia:
Risk factors: CVA, alcoholism, altered mental status / Rocephin (ceftriaxone) 1 gm IV STAT x 1 dose
AND
Clindamycin 600 mg IV STAT x 1 dose / Zosyn (piperacillin/tazobactam)
4.5gm IV STAT x 1 dose
AND/OR
MRSA Pneumonia:
Risk factors: Hemodialysis, IV drug abuse, Indwelling CVC / Vancomycin 1000 mg 1250 mg 1500 mgIV STAT x 1 dose
OR
Critical Care ONLY:
Zyvox (linezolid) 600 mg IV STAT x 1 dose
OR
Pneumonia related to hospiliazation for ≥ 48 hrs: 2016 IDSA guidelines recommend 7 day treatment with clinical improvement
Hospital Acquired Pneumonia (HAP) without ventilator support, septic shock or structural lung disease / Zosyn (piperacillin/ tazobactam) 4.5 gm IV STAT x 1 dose
AND
Vancomycin 1000 mg 1250 mg 1500 mg IV STAT x 1 dose / Documented Penicillin Allergy
Merrem (meropenem) 1 gm IV STAT x 1 dose
AND
Vancomycin 1000 mg 1250 mg 1500 mg IV STAT x 1 dose
Hospital Acquired Pneumonia (HAP)withventilator support, septic shock, or structural lung disease / Zosyn (piperacillin/ tazobactam) 4.5gm IV STAT x 1 dose
AND
Cipro (ciprofloxacin) 400 mg IV STAT x 1 dose
AND
Vancomycin 1000 mg 1250 mg 1500 mg IV STAT x 1 dose / Documented Penicillin Allergy
Merrem (meropenem) 1 gm IV STAT x 1 dose
AND
Cipro (ciprofloxacin) 400 mg IV STAT x 1 dose
AND
Vancomycin 1000 mg 1250 mg 1500 mg IV STAT x 1 dose
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
Sepsis due to UTI / Rocephin(ceftriaxone) 1 gm IV STAT x 1 doseAND ADD
Gentamicin 5 mg/kg IV STAT x 1 dose (Round to the nearest 20 mg) / Fortaz (ceftazidime) 1 gm IV STAT x 1 dose
AND ADD
Gentamicin 5 mg/kg IV STAT x 1 dose
(Round to the nearest 20 mg)
Sepsis due to Intraabdominal or Unknown source / Rocephin(ceftriaxone) 1 gm IV STAT x 1 dose
AND
Flagyl (metronidazole) 500 mg IV STAT x 1 dose / Zosyn(piperacillin/tazobactam) 4.5gm IV STAT x 1 dose / Invanz (ertapenem) 1 gm IV STAT x 1 dose
AND/OR
Sepsis with risk of MRSA / Vancomycin ____ mg IV STAT x 1 dose
OR
Sepsis due to Bacterial
Meningitis / Decadron (dexamethasone) 4 mg IV STAT x 1 dose (Administer within 30 min of antibiotics)
Rocephin (ceftriaxone) 2 gm IV STAT x 1 dose
Vancomycin 20 mg/kg IV STAT x 1 dose (Round up to nearest 250 mg, max 2000 mg)
Ampicillin 2 gm IV STAT x 1 dose (add for patient > 50 yo or immunocompromised)
OR
Sepsis due to Skin/Soft Tissue Infections
Ancef not indicated as monotherapy for Severe Sepsis/Septic Shock / Unasyn(ampicillin/sulbactam) 3 gm IV STAT x 1 dose
AND ADD
Vancomycin
1000 1250 1500 mg
IV STAT x 1 dose
OR
Ancef (cefazolin) 1 gm IV STAT x 1 dose
AND ADD
Vancomycin
1000 1250 1500 mg
IV STAT x 1 dose
**Consider using Vancomycin for cellulitis with abscess or ulceration / Zosyn(piperacillin/ tazobactam) 4.5 gm IV STATx 1 dose
AND
Vancomycin
1000 1250 1500 mg
IV STAT x 1 dose / Fortaz (ceftazidime) 1 gm IV STAT x 1 dose
AND
Clindamycin 600 mg IV STAT x 1 dose
AND
Vancomycin
1000 1250 1500 mg
IV STAT x 1 dose
PRN MEDICATIONS:
- Tylenol (acetaminophen) ____ mg po per rectum x 1 dose prn for ______
- Motrin (ibuprofen) ____ mg po x 1 dose prn for ______
______
DateTimeED Physician SignaturePID Number
Copy to pharmacy
FORM 3-39412 REV. 08/2017 Page 1 of 4