Severe Sepsis Screening Tool: A Case Study

Evaluation for Severe Sepsis Screening Tool

Instructions: Use this optional tool to screen patients for severe sepsis in the emergency department, on the wards, or in the ICU.
1. Is the patient’s history suggestive of a new infection?
_ Pneumonia, empyema _ Bone/joint infection
_ Urinary tract infection _ Bloodstream catheter infection
_ Acute abdominal infection _ Wound infection
_ Meningitis _Implantable device infection
_ Skin/soft tissue infection _ Endocarditis
_ Other ____________
___ Yes ___No
2. Are any two of following signs & symptoms of infection both present and new to the patient? Note: laboratory values may have been obtained for inpatients but may not be available for outpatients.
_ Hyperthermia > 38.3 °C (101.0 °F) _ Acutely altered mental status
At the physician’s discretion obtain: UA, chest x-ray, amylase, lipase, ABG, CRP, CT scan.

3. Are any of the following organ dysfunction criteria present at a site remote from the site of the infection that are not considered to be chronic conditions? Note: the remote site stipulation is waived in the case of bilateral pulmonary infiltrates.
_ SBP < 90 mmHg or MAP < 65