Sepsis
Sepsis is a life-threatening emergency that can progress rapidly. Early recognition and aggressive treatment in the field — particularly fluid resuscitation and timely pre-arrival notification — directly affect patient outcomes. The three most critical prehospital actions are: recognizing potential Sepsis/SIRS, initiating early fluid resuscitation, and activating a Sepsis Alert before arrival.
Systemic Inflammatory Response Syndrome (SIRS)
A generalized inflammatory response requiring at least 2 of the following criteria to be present:
SIRS Criteria (≥2 required) — LEMSA PD# XXXX
- Body temperature >38°C (100.4°F) or <36°C (96.8°F)
- Respiratory rate >20 breaths per minute
- Heart rate >90 bpm
- Systolic BP <90 mmHg
- Waveform capnography (if available) <25 mmHg
When to Treat and Alert
Both of the following must be present before initiating treatment and pre-arrival notification:
1. Confirmed or suspected infection (any of the following)
- History from patient, family, or care facility
- Signs or symptoms of UTI, respiratory, or skin infection
- Older or immune-compromised adult with unexplained altered mental status (no acute stroke per LEMSA PD# XXXX)
2. Any 2 of the SIRS criteria listed
- Temperature, Respiratory Rate, Heart Rate, SBP, or EtCO₂ thresholds (see left)
Over-Alert
A Sepsis pre-alert sent when the patient does not meet ≥2 SIRS criteria and/or confirmed infection. Tracked for QI purposes — a small number of over-alerts is expected and not penalized.
Source: LEMSA PD#### — Sepsis/Septic Shock · Next Review 09/01/26