This guideline covers the recognition, diagnosis and early management of sepsis for all populations. The guideline committee identified that the key issues to be included were: recognition and early assessment, diagnostic and prognostic value of blood markers for sepsis, initial treatment, escalating care, identifying the source of infection, early monitoring, information and support for patients and carers, and training and education.
In September 2017, we updated recommendation 1.4.3 to properly divide 2 bullet points. Table 3 and recommendations 1.4.9 and 1.9.2 were corrected to give oxygen saturation as less than 92% in air. Table 2 was amended to include tympanic temperature as a moderate risk factor. Table 3 was amended to add pallor of skin, lips or tongue as an intermediate to high risk factor, and recommendation 1.4.9 was amended to remove pale or flushed as an intermediate risk factor. Minor corrections for consistency were also made between the recommendations, tables and algorithms. The accompanying algorithms have also been redesigned to help with readability.
The guideline includes recommendations on:
- Identifying and assessing people with suspected sepsis
- Risk factors and risk stratification for sepsis
- Managing suspected sepsis in acute hospital settings and out of hospital
Who is it for?
- People with sepsis, their families and carers
- Healthcare professionals working in primary, secondary and tertiary care
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.