vary vitals based on group interventions. Establish large bore IV and/or 2nd site Labs obtained with IV start? **Have IV supplies available Obtain labs Lactate, blood cultures, obtain UA/UC, electrolytes, BUN, Creat., liver panel, ionized Ca, Mg, Phosphorous, PT/INR, type and screen, etc. **Have lab collection tubes available Note: Last CBC at 0630 Indwelling Urinary Catheter If placed 150mL of amber – colored urine return **Have catheter supplies available Note: Iodine allergy Consider source of infection Cultures Chest x-ray Variation: could have a simulated red area around current IV could consider as a source of infection – Severe Sepsis Bundle Orders **Have paper copy if sample electronic medical record not available (use facility specific) 30 mL/kg crystalloid bolus Discontinue current IV fluids ** Have different bags of IV fluid available Antibiotic administration Note type of antibiotics ordered Note: Allergy to PCN and dosage: **Have secondary IV tubing and IV “pretend” antibiotic’s available Tip: consider use of barcoding or checking patient identification Vital signs following fluid bolus: Blood pressure: 80/46 Pulse: 150 Sinus Tach on monitor – Temp: 100.2 (tympanic) Oxygen Saturation: 89% on 2L Respirations: 20 Remains confused verbal, but answers questions – inappropriately Read Lab results to group Have paper copy for group to read Lactate: 4.2 WBC: 2.0 Hemoglobin:
vary vitals based on group interventions. Establish large bore IV and/or 2nd site Labs obtained with IV start? **Have IV supplies available Obtain labs Lactate, blood cultures, obtain UA/UC, electrolytes, BUN, Creat., liver panel, ionized Ca, Mg, Phosphorous, PT/INR, type and screen, etc. **Have lab collection tubes available Note: Last CBC at 0630 Indwelling Urinary Catheter – If placed 150mL of amber colored urine return **Have catheter supplies available Note: Iodine allergy Consider source of infection Cultures Chest x-ray Variation: could have a simulated red area around current IV – could consider as a source of infection Severe Sepsis Bundle Orders **Have paper copy if sample electronic medical record not available (use facility specific) 30 mL/kg crystalloid bolus Discontinue current IV fluids ** Have different bags of IV fluid available Antibiotic administration Note: Allergy to PCN **Have secondary IV tubing and “pretend” IV antibiotic’s available Tip: consider use of barcoding or checking patient identification Note type of antibiotics ordered and dosage: Vital signs following fluid bolus: Blood pressure: 80/46 Pulse: 150 – Sinus Tach on monitor Temp: 100.2 (tympanic) Oxygen Saturation: 89% on 2L Respirations: 20 Remains confused – verbal, but answers questions inappropriately Read Lab results to group Have paper copy for group to read Lactate: 4.2 WBC: 2.0 Hemoglobin: