Box 1.

Sepsis definitions and the Sepsis Six. Gold standard against which responses were scored (2001 International Sepsis Definitions Conference).9

SIRS
  • heart rate >90 bpm

  • respiratory rate >20/min

  • temperature >38.3°C or <36°C

  • altered mental status

  • blood glucose >7.7 mmol/L in a non-diabetic patient

  • white cell count <4,000/μL or >12,000/μL.

Sepsis:
Suspicion of infection with two or more SIRS criteria.
Severe sepsis: Sepsis with organ dysfunction.
Septic shock: Sepsis with hypotension despite adequate fluid resuscitation.
The Sepsis Six (to be completed within 1 hour):
  • oxygen

  • intravenous antibiotics

  • intravenous fluids

  • venous lactate

  • blood cultures

  • documentation of urine output.

  • For SIRS criteria, an answer of tachycardia was marked partially correct whereas heart rate >90 bpm was marked fully correct. SIRS = systemic inflammatory response syndrome.