Key Points to Remember Ask yourself “Is this patient really sick? Or do they look well” and check their observations If they look sick, assess the patient in an ABCDE approach Look at the bedside observations, recent blood results and previous microbiology. Does the patient fulfil SIRS criteria? Give oxygen (as determined by O2 saturations), Get IV access early on Take blood to send for FBC, CRP, U&Es, LFTs, Clotting, amylase and a VBG (for a lactate). Also send off blood cultures. Give fluid challenge (20-30ml/Kg of crystalloid) if any sign of shock Take a brief history of the presenting features during resuscitation, including for a potential source of sepsis With a septic patient aim for a urine output of >0.5/mls/kg/hr and repeat the plasma lactate within an hour to make sure that things are going in the right direction. Remember the 5 W’s (Wind, Water, Walking, Wound, Wonder Drugs) as causes of a post-operative fever If you suspect an infection, focus on the potential source If you suspect the chest, get a chest x-ray and send a sputum sample to the lab If you suspect the urine, perform a urine dip and send a midstream sample to the lab Examine the wound for signs of infection and send wound swabs for culture Check your local antibiotics policy to choose the most appropriate antibiotic. When prescribing antibiotics start SMART then FOCUS as you obtain the results of microbiology By TeachMeSurgery (2020) Fig 1The 5 Ws. Rate This Article