SEPSIS

BUZZWORD- SEPSIS PLUS ORGAN DYSFUNCTION = SEVERE SEPSIS

.ICD10SEPSIS

• Infection plus SIRS
• SIRS criteria (need 2)
° T >100.9 or < 96.8
° HR > 90
° RR >20
° WBC >12,000 or < 4,000  Only query if there is evidence of organ dysfunction
– Severe sepsis
• Meets criteria for sepsis plus organ dysfunction
Query if sepsis is documented if a patient has positive 2 /4 SIRS + infection (or suspected infection) + SOFA score of 2 or more. If patient has SIRS and a lactate > 3 we can also query for severe sepsis
– Organ Dysfunction
° Relative hypotension- drop in SBP . 40 MM hg from baseline
° Hypotension (MAP < 65)
° Lactate >2
° Decreased capillary refill, skin mottling or cyanosis
° Ileus or absent bowel sounds
° AMS (GCS < 15)
° INR >1.5
° Platelets < 100,000 • Creatinine > 2 (above baseline)
° Urine output < 0.5cc/kg/hr
° Acute resp failure
° Bilirubin >2
° Sofa score >2