APPENDIX A: SEPSIS PATIENT MANAGEMENT CHECKLIST

If sepsis is suspected, the following checklist should be employed to begin treatment and set up a safety net for ongoing patient care:

- Placement of 2 IV access points (Large bore IV/IO).
- Collect blood cultures x2 (if available).
- Start IVF with goal resuscitation of adequate urine output, up to maximum bolus of 30ml/kg (usually about 2-3 Liters). See Resuscitation recommendations.
- Consider placement of advanced monitoring equipment (if available).
- Place a Foley catheter.
- Monitor all vital signs and continuously trend heart rate, blood pressure, respiratory rate, and mental status every 15 minutes on a flowsheet. (See JTS Documentation PFC CPG). Temperature and urine output should be documented hourly.
- Place on oxygen if indicated and available (for SpO2 < 90%).1
- Ensure a secure airway is in place, or the equipment for a definitive airway is on hand along with the elements of M.S.M.A.I.D. (See JTS Airway Management for Prolonged Field Care CPG.)
- Search for the source of infection. Address this as appropriate (wound care, removal of infected catheters, surgical consultation, etc.)
- Give the most appropriate antibiotics.
- Call telemedicine consultant early and often.
- Take/Give Approach: Take – Vital signs, neurologic assessment, wound/ skin infection exams, serum lactate level, urine output (Foley catheter), rapid tests. Give – Antibiotics, Fluids, Oxygen (if available), Vasopressors (with telemedicine).
- If providing nutrition, monitor for signs of GI upset or obstruction: nausea, abdominal pain, and abdominal distension.

1. Ginde AA. Strategy to Avoid Excessive Oxygen (SAVE-O2) in Critically Ill Trauma Patients: A Multicenter Cluster-Randomized, Stepped Wedge Trial for Targeted Normoxemia. Scientific Plenary Presentation (MHSRS-23-10446), Military Health System Research Symposium; August 14, 2023.