Sepsis Evidence Based Practice

To be completed within three hours:

  1. Measure lactate level.
  2. Obtain blood cultures prior to administration of antibiotics.
  3. Administer broad spectrum antibiotics. 
  4. Administer 30ml/kg crystalloid for hypotension or lactate ≥ 4mmol/L.

To be completed within six hours:

  1. Apply vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a Mean Arterial Pressure (MAP) ≥65mm Hg.
  2. 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