Scenario A
- Patient has suspected or confirmed infection.
- Does patient have acute life-threatening organ dysfunction?
- Does the patient look sick according to your clinical judgment e.g. unable to stand?
- Alteration of mental status (ACVPU).
- SpO2 >90% on room air.
- Tachypnea RR >22 breaths/minute.
- Systolic blood pressure <90 mmHg or decrease >40 mmHg from baseline, mean arterial pressure <65-70 mmHg.
- Skin mottling delayed capillary refill.
- Decrease in urine output (< 0.5 ml/kg/hr) or not passed urine for more than 12 hours.
- If available, laboratory values: creatinine >2.0 mg/dL, bilirubin >2 mg/dL, platelet count <100,000/μL (or 100 K/μL), coagulopathy (INR > 1.5, aPTT >60), or lactate >2 mmol/L.
If YES, activate 3-hour sepsis bundle
Scenario B