Aim to complete within 1 hour
TAKE 3
- BLOOD CULTURES: Take blood cultures prior to giving antimicrobials unless this leads to delay > 45minutes. Other cultures as indicated by history and examination.
- BLOOD TESTS: Point of care lactate (venous or arterial). FBC, U&E, LFTs +/- Coag. Other tests and investigations as indicated.
- URINE OUTPUT: Assess urinary output as part of volume/perfusion status assessment. For patients with sepsis or septic shock start hourly urinary output measurement.
GIVE 3
- OXYGEN: %. Range 21% (R/A) to 100%. Titrate to saturations of 94-98%, 88-92% in chronic lung disease.
- FLUIDS: Volume in 1st hour mls.
- Patients who present with hypotension should receive 30mls/kg of a balanced salt solution within 1 hour of presentation.
- Start pressors in patients who are fluid unresponsive.
- Patients with hypoperfusion should receive fluid to restore perfusion using a bolus and review technique. 500ml boluses are recommended but may be amended based on clinical context. See fluid resuscitation algorithm.
- ANTIMICROBIALS: Give antimicrobials as per local antimicrobial guideline based on the site of infection, community or healthcare acquired and the patients allergy status. Assess requirement for source control.
Type: Dose: Time Given: