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Risk stratification tool for adults, children and young people aged 12 years and over with suspected sepsis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Risk stratifification tool for adults, children and young people aged 12 years and over with suspected sepsis

Category

High risk criteria

Moderate to high risk criteria

Low risk criteria

History

Objective evidence of new altered mental state

History from patient, friend or relative of new onset of altered behaviour or mental state

History of acute deterioration of functional ability Impaired immune system (illness or drugs including oral steroids)

Trauma, surgery or invasive procedures in the last 6 weeks

Normal behaviour

Respiratory

Raised respiratory rate: 25 breaths per minute or more

New need for oxygen (more than 40% FiO2) to maintain saturation more than 92% (or more than 88% in known chronic obstructive pulmonary disease)

Raised respiratory rate: 21-24 breaths per minute

No high risk or moderate to high risk criteria met

Blood pressure

Systolic blood pressure 90 mmHg or less or systolic blood pressure more than 40 mmHg below normal

Systolic blood pressure 91-100 mmHg

No high risk or moderate to high risk criteria met

Circulation and hydration

Raised heart rate: more than 130 beats per minute

Not passed urine in previous 18 hours.

For catheterised patients, passed less than 0.5 ml/kg of urine per hour

Raised heart rate: 91-130 beats per minute (for pregnant women 100-130 beats per minute) or new onset arrhythmia

Not passed urine in the past 12-18 hours

For catheterised patients, passed 0.5-1 ml/kg of urine per hour

No high risk or moderate to high risk criteria met

Temperature

Tympanic temperature less than 36°C

Skin

Mottled or ashen appearance Cyanosis of skin, lips or tongue Non-blanching rash of skin

Signs of potential infection, including redness, swelling or discharge at surgical site or breakdown of wound

No non-blanching rash

Recognise that adults, children and young people aged 12 years and over with suspected sepsis and any of the symptoms or signs below are at high risk of severe illness or death from sepsis:

  • objective evidence of new altered mental state
  • respiratory rate of 25 breaths per minute or above, or new need for 40% oxygen or more to maintain oxygen saturation more than 92% (or more than 88% in known chronic obstructive pulmonary disease)
  • raised heart rate: more than 130 beats per minute
  • systolic blood pressure of 90 mmHg or less, or systolic blood pressure more than 40 mmHg below normal
  • not passed urine in previous 18 hours (for catheterised patients, passed less than 0.5 ml/kg/hour)
  • mottled or ashen appearance
  • cyanosis of the skin, lips or tongue
  • non-blanching rash of the skin

The UK Sepsis Trust have produced a form for evaluation of possible sepsis for use in primary care (2):

 

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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