Fever/Sepsis — Adult Algorithm

What infection precautions are considered in fever/sepsis?

Contact, droplet, and/or airborne precautions, if indicated.

What vital sign is obtained first in fever/sepsis?

Temperature.

What temperature defines fever in the sepsis protocol?

100.4°F or greater.

What monitoring is applied for a febrile patient?

Cardiac monitor.

What assessment is repeated for a febrile patient along with the monitor?

Vital signs.

What ECG is obtained for a febrile patient?

12 lead ECG.

What glucose test is done for a febrile patient?

Blood glucose analysis.

When is IV/IO access obtained in fever/sepsis?

If indicated.

What is the dose of ibuprofen for fever?

400 to 800 mg.

How is ibuprofen administered for fever?

PO.

What is the dose of acetaminophen for fever?

1000 mg.

How is acetaminophen administered for fever?

PO.

What BP defines hypotension in fever/sepsis?

Less than 90 mmHg.

What is the dose of normal saline bolus for septic hypotension?

1 liter.

How is the septic fluid bolus administered?

IV/IO, if indicated.

When can the septic fluid bolus be repeated?

If lungs remain clear.

When is norepinephrine considered in sepsis?

If hypotension does not improve with fluid.

What is the dose of norepinephrine for septic shock?

0.1 mcg/kg/min.

What is the max dose of norepinephrine for septic shock?

0.5 mcg/kg/min.

What SBP is norepinephrine titrated to in sepsis?

90 mmHg or greater.

What notification is made when SIRS criteria are met?

Code Sepsis.

What is the final step of the fever/sepsis protocol?

Transport.