Rapid Response & Sepsis Quickcards

Sepsis Recognition & Immediate Actions (card)

Recognition cues — consider sepsis when there is infection plus any of the following:

• Altered mental status (new)
• Respiratory rate ≥ 22 breaths/min or marked increase from baseline
• Systolic BP ≤ 100 mmHg or new hypotension
• Temperature > 38°C or < 36°C, HR > 90 bpm, or abnormal white blood cell count (SIRS features may help but follow local guidance)
• Elevated lactate (if available) suggests higher risk

Immediate bedside actions — do these now while arranging escalation:

• Call for help; tell a colleague “possible sepsis” and ask for immediate assistance
• Place patient on monitor and provide supplemental oxygen to target acceptable saturation per local policy
• Establish IV/IO access; obtain blood cultures before antibiotics when this does not meaningfully delay care
• Draw stat labs: lactate, CBC, metabolic panel, blood cultures (as per local policy)
• Give crystalloid bolus for hypotension or lactate elevation (follow local protocol for volume and targets)
• Administer broad-spectrum antibiotics as soon as available per local sepsis protocol (timing expectations vary—follow local policy)
• Document time zero (recognition) and actions taken

Timing goals (examples — confirm local targets)

• Recognition → escalation: within minutes
• Recognition → initial antibiotics: per local protocol (ensure pharmacy/antibiotic access is rapid)
• Recognition → initial resuscitation actions (O2, IV access, labs): immediate

Customizable escalation contacts (replace with local numbers):

• Ward RN / Primary nurse: {name/extension}
• Charge nurse: {extension}
• Rapid Response Team (RRT): {number}
• ICU consult: {pager/phone}
• On-call physician: {name/phone}
• Pharmacy stat: {number}

Deterioration & Escalation Ladder (card)

This card focuses on early stabilization and a clear escalation ladder when a patient’s condition worsens.

Immediate bedside stabilization

• Ensure airway patency; open airway and position for breathing
• Support breathing: high-flow O2, consider bag-valve if ventilation inadequate
• Circulation: check pulses, monitor BP; give IV bolus per protocol if hypotensive
• Control obvious causes: hemorrhage control, dextrose for hypoglycemia if suspected, stop offending meds if indicated
• Prepare for advanced airway and transfer to higher level of care if not responding

Escalation ladder (use this order unless local policy specifies otherwise)

1. Call for bedside help (ask for specific role: e.g., RN to bedside)
2. Inform charge nurse
3. Contact primary team/attending or on-call clinician
4. Activate Rapid Response Team (RRT) or equivalent
5. Request ICU consult or post-stabilization transfer to higher acuity unit
6. If immediate arrest or life-threatening instability, call code/medical emergency number

Documentation & handoff

• Record times of recognition, actions, and escalation calls
• Use a structured handoff script: Situation, Background, Assessment, Recommendation (SBAR) when transferring responsibility

Customizable quick fields — fill these on your unit card:
RRT: {number} | Code: {number} | ICU bed coordinator: {number} | Transport: {number}

Deployment, Customization & Testing Guidance

These quickcards are tools, not substitutes for training or clear escalation protocols. Use the following steps to adopt and maintain them:

• Customize contact fields and local protocol touchpoints before printing.
• Size recommendations: 85 x 54 mm (credit-card) or 3 x 4 inches for pocket cards. Consider a badge-size and a larger resuscitation-cart version.
• Material: durable cardstock with lamination or plastic; consider a QR code linking to the full local protocol and checklists.
• Distribute with a short briefing and competency check during shifts; include in orientation for new staff.
• Test in simulation: run scenario drills at least quarterly and capture lessons for card refinement.
• Audit use and outcomes: collect brief feedback after activations to identify confusion, missing contacts, or untested assumptions.

Mal-hunger reminders: Do not rely solely on cards. Confirm role clarity, escalation ownership, equipment availability, and how cards map to local order sets and pharmacy workflows. Regular testing prevents single points of failure.

Quick implementation checklist

• Insert local phone/pager numbers and clinical leads.
• Review content with clinical governance, sepsis committee, and frontline staff.
• Print sample cards and pilot on one unit; collect feedback.
• Run simulation of at least one common deterioration scenario using the cards.
• Update cards after pilot and schedule periodic reviews (6–12 months or after major protocol changes).