Surviving Sepsis on wards: Resuscitation Bundles

Clinical scenario

Sepsis patients identified and resuscitated on the ward.

Audit question

Are we complying with the resuscitation bundles for patients with sepsis on the wards.

Method

Prospective audit of patients identified with sepsis on the ward.
Resuscitation bundle.

Serum lactate measured.
Blood cultures obtained prior to antibiotic administration.
From the time of presentation, broad-spectrum antibiotics administered within 3 hours for ED admissions and 1 hour for non-ED ICU admissions.
In the event of hypotension and/or lactate > 4mmol/L (36mg/dL):
Deliver an initial minimum of 20 ml/kg of crystalloid (or colloid equivalent)
Give vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mm Hg.
In the event of persistent arterial hypotension despite volume resuscitation (septic shock) and/or initial lactate > 4 mmol/L (36 mg/dl):
Achieve central venous pressure (CVP) of > 8 mm Hg.
Achieve central venous oxygen saturation (ScvO2) of > 70% .*

Comments

The aim of this audit is the measure the compliance with the SSC resuscitation bundles on the ward.
www.survivingsepsis.com

Audit Bottom Line

In progress

Record created on 28th March 2006 by John Butler