Protocol 2-440 - Fever / Sepsis

CMH EMS & MIH Protocols

EMD:

• No specific protocol.

EMR:

• Consider Oxygen to maintain SpO2 above 88%.
• Consider treating for shock.
• Fever greater than 102° F: Begin COOLING.
• Assess for SEPSIS:
• Adult: Suspected infection AND two or more of the following:
• Altered mental status,
• Hypotension (SBP less than 100), OR
• Tachypnea (respiratory rate greater than 22).
• Pediatric: Suspected infection AND BOTH of the following:
• One of the following:
• Temperature greater than 101.3° F OR
• Temperature less than than 96.8° F
• One of the following:
• Bradycardia for age OR
• Tachycardia for age OR
• Tachypnea for age
• Consider applying cardiac monitor limb leads.

EMT:

• Ensure completion of applicable items above.
• Assist ALS with Capnography.
• Perform Blood Sugar Check.
• Blood sugar less than 60 mg/dl: Refer to Protocol 2-572 - Hypoglycemia.

AEMT:

• Ensure completion of applicable items above.
• Consider IV LR in AC (left is preferred) with pigtail extension with 18 ga or greater. Refer to Protocol 2-583 - Hypotension / Shock for LR dose.

RN:

• Ensure completion of all applicable items above.
• Consider IO LR. Refer to Protocol 2-583 - Hypotension / Shock for LR dose.
• Meets SEPSIS criteria:
• If SBP less than 90 or MAP less than 70 after fluid bolus:
• Notify Emergency Room of incoming SEPTIC SHOCK patient.
• Attempt to initiate two large-bore IVs.
• Refer to Protocol 2-583 - Hypotension / Shock.
• Consider Dextrose or Glucose administration according to Protocol 2-572 - Hypoglycemia to meet a target blood sugar level of 180 mg/dl.
• Target scene time of 10 minutes.
• Notify Emergency Room of incoming SEPTIC patient.
• Fever greater than 102° F:

• Adult:	Pediatric:
  Acetaminophen NOT given within 4 hours: Consider Acetaminophen 325-650 mg PO. Acetaminophen giving within 4 hours: Consider Ibuprofen 200-400 mg PO.	Acetaminophen NOT given within 4 hours: Consider Acetaminophen Elixer 15 mg/kg PO. Click "calculate" to get dose. Acetaminophen giving within 4 hours: Consider Ibuprofen Elixer 10 mg/kg PO. Click "calculate" to get dose.

Medic:

• Ensure completion of all applicable items above.

CP:

• Ensure completion of all applicable items above.
• Refer to MIH Protocol 4-500 - Chronic Sepsis Management.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.