2nd August 2023

Investigation and Management

The UK Sepsis Trust ‘Sepsis Six’ bundle, which should be given within the first hour of identifying sepsis.

• ‘3 in’ –intravenous fluids, broad spectrum antibiotics and oxygen therapy (if required)
• ‘3 out’ –blood cultures (2 sets), serum lactate measurement and urine output

If patients are critically unwell, a discussion with intensive care may be required to consider central venous access, inotropes, or vasopressors.

• Inotropes: medications which can increase cardiac output by increasing cardiac contractility
• Vasopressors: increase blood pressure by increasing peripheral vascular resistance

These may be required to maintain perfusion pressure in patients with severely deranged observations and parameters, those in the high-risk criteria (table 2), and those not responding to initial treatments.