A person who presents to the ED with a fever, tachycardia, and treated with broad-spectrum antibiotics only to be sent home with a viral illness 1 hour later can be safely diagnosed as having sepsish.
There are several risk factors to sepsish:
- Acute onset 1-2 days of feeling a bit bad
- Unable to get appointment with GP, PCP, or family doctor
- Patient "too ill to take paracetamol"
- All over body pains, possibly complains of burning all over
- Urine more yellow than usual
- The complaint of "Worse I've ever felt!"- Take this seriously
Always manage using the following sepsish six-step protocol:
- Antibiotics, fluids, and IV paracetamol should always be initiated based on triage nurse observations. Do not wait for a doctor to review clinically.
- Ensure patient is managed in majors: it's important to reinforce the notion that this is a major illness early on.
- If the patient has an obvious history of gastroenteritis, they may be suffering from Tazocin deficiency. Do not hold back on the IVs.
- Ensure that they are accompanied by an anxious partner or relative who can helpfully suggest things like "How do you know it's not meningitis?"
- If you suspect manflu then involve ITU early and liaise with the tertiary centre for manflu for a bed on their ward.
- It's important that you treat the patient dismissively when the blood results come back negative, in fact try not to see them. Get the nurse to disconnect all the wires and say they can go home with Lemsip.
- C. diff
- Chipotle Mexican Grill
- Flagyl (Metronidazole)
- Zosyn (Piperacillin-Tazobactam)