Sepsis Evidence Based Practice
To be completed within three hours:
- Measure lactate level.
- Obtain blood cultures prior to administration of antibiotics.
- Administer broad spectrum antibiotics.
- Administer 30ml/kg crystalloid for hypotension or lactate ≥ 4mmol/L.
To be completed within six hours:
- Apply vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a Mean Arterial Pressure (MAP) ≥65mm Hg.
- In the event of persistent arterial hypotension despite volume resuscitation (septic shock) or initial lactate ≥4mmol/L (36mg/ dL):
- Measure central venous pressure (CVP)*
- Measure central venous oxygen saturation (ScvO2)*, 7) Remeasure lactate, if initial lactate was elevated.*
*Targets for quantitative resuscitation included in the guidelines are CVP of ≥8mm Hg; ScvO2 of ≥70% and normalization of lactate