Mr. Green is admitted to the medical unit this morning from the E.D. with probable urosepsis. On admission his blood pressure is 144/74, HR 88, temperature 99.6. Blood cultures and lactate (normal result) were drawn in the E.D. and IV antibiotics were started. WBC is 18,000. Urine is positive for WBCs and blood.
Several Hours Later….
It is now 4am and the CPA reports some changes in the VS to the nurse: BP 88/54, HR 122, resp 28, temp 100.6. The nurse reviews the VS from the previous hours and notes some trending
8pm: BP 124/72, HR 98, resp 18
12MN: BP 100/64, HR 110, resp 24
• Significant changes in VS
• Signs and symptoms of severe sepsis have developed
• Presumed increased cardiac output and decreased SVR (compensation for dilated vascular bed)
Actions:
• Notify physician: prepare to administer IV fluid boluses
• Rapid Response Team
• Transfer to higher level of care: anticipate immediate supportive care needs (vasopressors)
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Date last modified: January 7, 2013.
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