Page 65 - ATP-P 11th Ed

Sepsis Management
a. Blunt or penetrating injuries may cause sepsis in untreated or undertreated patients
b. Early recognition of impending sepsis and immediate treatment are imperative to im-
prove changes of survival SECTION 1
c. Maintain a high degree of suspicion for signs of early and/or progressing sepsis while
performing continuous triage
d. Sepsis is defined as suspected or proven infection plus evidence of end organ dysfunction.
17
e. The National Early Warning Score (NEWS) is an aggregate scoring system indicating
early physiologic derangements:
Table 13 Physiologic Parameters and NEWS Score
Physiologic Parameters 3 2 1 0 1 2 3
Respiratory Rate ≤8 9–11 12–20 21–34 ≥25
Oxygen Saturation ≤91 92–93 94–95 ≥96
Temperature ≤35.0 35.1–36.0 36.1–38.0 38.1–39.0 ≥39.1
Systolic BP ≤90 91–100 101–110 111–219
Heart Rate ≤40 41–50 51–90 91–110 111–130 ≥131
Level of Consciousness A V,P,U
f. For the purposes of this guideline, a NEWS score of >2 is used to increase the sensitivity
for detection of and evaluation for sepsis.
g. Early teleconsultations should be used for any signs of sepsis
h. Additional parenteral antibiotics may be required to treat sepsis as well as vasopressors.
i. All use of pressers should be administered by role-based approved protocols or telecon-
sultation approval.
NOTE: Surgical telemedicine consultation is highly recommended to guide management
of intra-abdominal infections (i.e., appendicitis, cholecystitis, diverticulitis, abdominal
abscess).

54 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 55