Sepsis Pocket Guide

First Dose IV Antibiotic Selections
See Order Sets for specifics and dosing

Infection Primary Therapy Severe Beta Lactam Allergy
Unknown Source/Site Piperacillin/Tazobactam + Vanc Aztreonam + Vanc
Pneumonia CAP Ceftriaxone + Azithromycin Moxifloxacin OR Levofloxacin
Pneumonia HCAP Piperacillin/Tazobactam + Vanc Cipro + Vanc
Urinary – Community Ceftriaxone Levofloxacin OR Cipro + Vanc
Urinary – Hospital/ Catheter Piperacillin/Tazobactam Levofloxacin OR Cipro + Vanc
CNS Ceftriaxone + Vanc +/-Ampicillin Cipro + Vanc +/-TMP/SMX
Intraabdominal Piperacillin/Tazobactam Moxifloxacin + Metronidazole OR Levofloxacin + Metronidazole
Skin Cellulitis Ceftriaxone + Vanc Cipro + Vanc
Line/Catheter Cefepime + Vanc Cipro + Vanc
Necrotizing Fasciitis Piperacillin/Tazobactam + Vanc + Clinda Cipro + Vanc + Clinda
PID Gent + Clinda Gent + Clinda
C.difficile –severe Vanc PO + Metronidazole Vanc PO + Metronidazole

Documentation Guidelines

Document

  • Use the terms “severe sepsis” or “septic shock”and list the associated infection and organdysfunction
  • Clearly document present on admission (POA)status with clinical reasoning and associatedinfection
  • Include significant comorbities
  • If sepsis has been ruled out, clearly state inprogress notes and discharge summary
  • Avoid copy and paste
  • Include sepsis documentation in dischargesummary

DO NOT USE

  • Urosepsis, bactermia, SIRS
  • Sepsis when there is end organ dysfunction(use “severe sepsis” or “septic shock”)

Inpatient/ED Sepsis MPage in MedConnect

Populates SIRS/SEPSIS alert patients

  1. Log-in to MedConnect
  2. Select View then MedStar MPages
  3. Select ED Sepsis MPage or Hospital Sepsis MPage
  4. ED Sepsis MPage (active ER patients)
    1. Select Facility, Select Patient
  5. Hospital Sepsis MPage
    1. Select Facility, Select Unit
    2. Default view: alerts within past 4 days
    3. Filter alerts: Sepsis, SIRS, Last 24Hrs,
      Most Recent

Sepsis Identification and Treatment

Sepsis Order Sets

SEPSIS ORDER SETS
Cerner (MWHC, MGUH, MFSMC, MHH, MUMH, MGSH)
NAME(S) HOW TO ACCESS
ED ED Sepsis Evaluation ED Quick Orders Page
INPT Sepsis Order Set-inpatient Powechart/Orders
Cerner (MSMH)
ED ED-Sepsis — Adult
ED Sepsis — Pediatric		 PowerOrders
INPT Sepsis Orders
Sepsis Vasoactive Agents & Steroids		 PowerOrders
McKesson (MSMHC)
INPT Sepsis ICU/CCU Orders
Siemens (MMMC)
ED Sepsis Work Up
Sepsis Antibiotic		 EDIS/ED order sets
INPT Sepsis Antibiotic Therapy
Sepsis ICU Order Set
Sepsis Non-ICU Order Set		 Clinician View/Write
Orders/Order Sets/Supplemental