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User's Manual

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Table Of Contents
24 ProtocolWatch
310
Select Confirm when the check boxes reflect the current patient status.
Select
Remind 15 min if you want to delay filling out this screen. (When you enter the screen manually
this key will be a
Cancel key, as no action is required in this case.)
Changing Conditions
The window reappears if:
• a previously fulfilled criteria is again fulfilled
• a new HR or RR criteria is fulfilled,
• the HR or RR value which previously fulfilled the criteria now triggers a
** RR HIGH, ** HR HIGH
alarm or a
***TACHY xxx > yy alarm,
• after 8 hours (configurable to 12 hours) if at least one infection sign is still present.
Two Or More Infection Signs Or Symptoms Confirmed
If you have confirmed two or more infection signs in the first Severe Sepsis Screening window, a new
pop-up window appears asking
Is the patient history suggestive of a new infection?.
If you select
Yes, the next screen appears requesting a lactate measurement.
If you select
No, the screening phase continues and the first Severe Sepsis Screening window reappears
in the situations described in Changing Conditions above.
Lactate Measurement
To enter the Lactate value, select the Enter Lact key. If the value entered is > 4 mmol/l the check box
is automatically checked.
Select
Confirm when a value has been entered. What follows depends on the Lactate value:
•If Lactate is > 4 mmol/l: the value meets the criteria for severe sepsis and a window appears
recommending authorized clinician review before entering the Sepsis Resuscitation Bundle.
•If Lactate is ≤ 4 mmol/l: a further window appears requiring your input to determine on the
basis of blood pressure values whether the patient meets the criteria for severe sepsis.
Hypotension Evaluation
If the Lactate value was not above 4 mmol/l, the next window asks whether the patient has persistent
hypotension.
The protocol defines Hypotension as:
• SBP < 90mmHg (12.0kPa), or
• MAP < 65mmHg (9.0kPa), or
• SBP decrease > 40mmHg (5.0kPa) below baseline.
You can see this definition in the window by selecting
Show Details.
If the patient has persistent hypotension as defined, select
Yes. This acknowledges that the patient
meets the criteria for severe sepsis and a final window appears recommending authorized clinician
review before entering the Sepsis Resuscitation Bundle.
If the patient does not have persistent hypotension, select
No. After an hour a screen appears asking Is
the previously acknowledged infection still present?
.