Polito et al developed a score that can be used by Emergency Medical Service (EMS) personnel to screen a patient for severe sepsis. To improve performance it is necessary to improve the pretest probability. The authors are from Emory University in Atlanta and Northwestern University in Chicago.
Patient selection: sick adult (age >= 18 years)
Initial physiologic assessment – all 3 of the following:
systolic blood pressure < 110 mm Hg
heart rate > 90 beats per minute
respiratory rate > 20 breaths per minute
Exclusions:
traumatic injury
cardiac arrest
pregnancy
psychiatric emergency
confirmed toxic exposure
A patient who meets all 3 of the physiologic findings and has none of the alternative diagnosis is then screened using the PreSS.
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