Table 1 NICE Risk of severe illness or death from sepsis

History

Objective evidence of new altered mental state

History from patient, friend or relative of new onset of altered behaviour or mental state

History of acute deterioration of functional ability

Impaired immune system (illness or drugs including oral steroids)

Trauma, surgery or invasive procedures in the last 6 weeks

Normal behaviour

Respiratory

Raised respiratory rate: 25 breaths per minute or more

New need for oxygen (more than 40% FiO2) to maintain saturation more than 92% (or more than 88% in known chronic obstructive pulmonary disease)

Raised respiratory rate: 21–24 breaths per minute

No high risk or moderate to high risk criteria met

Blood pressure

Systolic blood pressure 90 mmHg or less or systolic blood pressure more than 40 mmHg below normal

Systolic blood pressure 91–100 mmHg

No high risk or moderate to high risk criteria met

Circulation and hydration

Raised heart rate: more than 130 beats per minute Not passed urine in previous 18 h.

For catheterised patients, passed less than 0.5 ml/kg of urine per hour

Raised heart rate: 91–130 beats per minute (for pregnant women 100–130 beats per minute) or new onset arrhythmia

Not passed urine in the past 12–18 h

For catheterised patients, passed 0.5–1 ml/kg of urine per hour

No high risk or moderate to high risk criteria met

Temperature

Tympanic temperature less than 36 °C

Skin

Mottled or ashen appearance Cyanosis of skin, lips or tongue Non-blanching rash of skin

Signs of potential infection, including redness, swelling or discharge at surgical site or breakdown of wound

No non-blanching rash