Executive summary
- Definition: Life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Tool: NEWS2 is the mandatory stratification tool for adults.
- Action: "Think Sepsis" at every vital sign check. Any NEWS2 ≥5 or single Red Flag = Urgent Action.
Risk Stratification (Adults)
- High Risk (Red Flag) - Immediate 999/Transfer:
- Objective: SBP <90 mmHg, HR >130, RR >25, O2 Sats <91% (or <88% in COPD), Lactate ≥2.0 mmol/L.
- Subjective: New confusion (AVPU < A), non-blanching rash, mottled skin, cyanosis, anuria (18h).
- Moderate Risk (Amber Flag):
- Review by senior clinician required. Consider hospital referral if no clear source or rapid deterioration likely.
- Criteria: Relatives concerned, acute kidney injury (mild), immunosuppression, recent surgery/trauma/birth (6 weeks).
Management (The Sepsis Six)
To be completed within 1 hour of Red Flag recognition:
- Oxygen: Aim 94-98% (88-92% COPD).
- Blood Cultures: Before antibiotics.
- IV Antibiotics: Broad spectrum (check local formulary, e.g., Piperacillin/Tazobactam or Ceftriaxone).
- IV Fluids: 500ml crystalloid bolus (max 30ml/kg) if hypotensive/lactate >2.
- Lactate: Venous or arterial (repeat if >2).
- Urine Output: Monitor hourly (catheterise if needed).
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.