Septris is Paused
Resume Game
No patient selected
SIRS + Sepsis Severe + Shock
Temp: BP: HR: RR: UO:
Physical Exam:
History and Physical:
Dr. Septris Says:
Dr. Septris Says:

Diagnostic Criteria for Sepsis - Infection, documented or suspected, and some of the following:

  • General variables
    • Fever (> 38.3°C); Hypothermia (core temperature < 36°C); Heart rate > 90/min or more than two sd above the normal value for age; Tachypnea; Altered mental status; Significant edema or positive fluid balance (> 20 mL/kg over 24 hr); Hyperglycemia (plasma glucose > 140 mg/dL or 7.7 mmol/L) in the absence of diabetes
  • Inflammatory variables
    • Leukocytosis (WBC count > 12,000/μL); Leukopenia (WBC count > 4000/μL); Normal WBC count with greater than 10% immature forms; Plasma C-reactive protein more than two sd above the normal value; Plasma procalcitonin more than two sd above the normal value
  • Hemodynamic variables
    • Arterial hypotension (SBP < 90 mm Hg, MAP < 70 mm Hg, or an SBP decrease > 40 mm Hg in adults or less than two sd below normal for age)
  • Organ dysfunction variables: See severe sepsis definition
  • Tissue perfusion variables
    • Hyperlactatemia (> 1 mmol/L); Decreased capillary refill or mottling

Severe Sepsis:

  • Severe Sepsis is Sepsis and new onset of any 1 organ dysfunction:
    • Sepsis-induced hypotension
    • Lactate above upper limits laboratory normal
    • Urine output < 0.5 mL/kg/hr for more than 2 hrs despite adequate fluid resuscitation
    • Acute lung injury with PaO2/FIO2 < 250 in the absence of pneumonia as infection source
    • Acute lung injury with PaO2/FIO2 < 200 in the presence of pneumonia as infection source
    • Creatinine > 2.0 mg/dL (176.8μmol/L)
    • Bilirubin > 2 mg/dL (34.2μmol/L)
    • Platelet count < 100,000μL
    • Coagulopathy (international normalized ratio > 1.5)

Septic Shock:

  • Septic Shock is Severe Sepsis with refractory hypotension
  • SBP < 90, MAP < 65 or a decrease of > 40 points in SBP from baseline that does not resolve or reoccurs after a 30 ml/kg fluid bolus
  • Return to Game
Submit Your Score!

Submit Score
View/Submit Action Log
Game Over

Septris is loading...