Sepsis Protocol

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3 HOUR INITIAL RESUSCITATION BUNDLE: 
Sepsis Risk Protocol GV#1277 for the following orders:
a.  Notify provider  
b.  Stat labs: Lactic Acid, CMP, CBCM, PT INR if not done in past 6 hours 
c.  Obtain blood cultures x 2 
d.  Obtain UA 
e.  Broad spectrum antibiotic for administration within 3 hours of presentation if not already given in the prior 3 hours. 
f.   For hypotension (SBP less than 90 mmHg) OR initial lactic acid level greater than or equal to 2mmol-kg, order 0.9% Sodium Chloride bolus (a total of 30mL-kg) for administration within 3 hours.
g. Focused exam to include vital signs, cardiopulmonary, capillary refill, pulse and skin findings
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6 HOUR SEPTIC SHOCK BUNDLE (Sepsis-induced hypotension OR lactic acid greater than 4mmol-kg)  
a.   Vasopressor for hypotension that does not respond to the fluid bolus to maintain MAP greater than or equal to 65mmHg for administration within 6 hours of presentation of shock 
b.   Focused exam to include vital signs, cardiopulmonary, capillary refill, pulse and skin findings 
c.   Repeat lactic acid level within 4 hours of initial lactate if greater than or equal to 2mmol-kg