Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and prompt management are crucial to reduce morbidity and mortality. While severe sepsis is often managed in hospital settings, primary care and outpatient clinics play a vital role in early detection and initial management of acute sepsis.

Neftaly’s Acute Care Protocol equips clinic providers with an evidence-based framework to identify, stabilize, and refer patients with suspected sepsis quickly and effectively.

1. Objectives of Acute Sepsis Management in Clinics

• Early recognition of sepsis using standardized criteria
• Rapid assessment and stabilization of airway, breathing, and circulation
• Initiation of timely interventions (fluids, oxygen)
• Prompt referral or transfer to emergency or inpatient care
• Patient and caregiver education on signs and follow-up

2. Recognizing Sepsis in the Clinic

Key Clinical Features:

• Fever or hypothermia
• Tachycardia (HR > 90 bpm)
• Tachypnea (RR > 20/min) or respiratory distress
• Altered mental status or confusion
• Hypotension (SBP < 90 mmHg or MAP < 65 mmHg)
• Signs of organ dysfunction (e.g., decreased urine output, jaundice)

Screening Tools:

• qSOFA Score: (Quick Sequential Organ Failure Assessment)
  • Respiratory rate ≥ 22/min
  • Altered mentation (GCS < 15)
  • Systolic BP ≤ 100 mmHg
    ≥ 2 indicates high risk and need for urgent action

3. Initial Assessment (ABCDE Approach)

• Airway: Ensure patent airway, prepare for advanced airway management if deterioration occurs
• Breathing: Assess oxygen saturation, provide supplemental oxygen to maintain > 94%
• Circulation: Measure pulse, blood pressure, capillary refill, establish IV access if possible
• Disability: Assess neurological status (AVPU/GCS)
• Exposure: Look for source of infection (wounds, catheters, respiratory signs)

4. Immediate Management in Clinic

• Administer oxygen therapy to maintain adequate saturation
• Initiate intravenous fluid resuscitation with isotonic crystalloids (e.g., 30 mL/kg) if hypotensive or signs of hypoperfusion present
• Monitor vital signs frequently
• Avoid delays in referral—early hospital transfer is essential
• Collect basic investigations if available: CBC, blood cultures, lactate, urinalysis

5. When to Refer or Transfer Immediately

• Signs of septic shock (persistent hypotension despite fluids)
• Rapidly worsening mental status
• Evidence of organ dysfunction (e.g., oliguria, hypoxia)
• Inability to manage airway or breathing adequately
• Lack of clinic resources for advanced management

6. Communication and Documentation

• Clearly document clinical findings, interventions, and communication with receiving facility
• Provide detailed handover including suspected infection source, vital signs, and treatments administered
• Notify emergency transport services early to minimize transfer delays

7. Patient and Caregiver Education

• Explain the seriousness of the condition and importance of hospital care
• Educate on recognizing warning signs such as worsening breathlessness, confusion, or decreased urine output
• Advise on medication adherence and follow-up after discharge

8. Prevention and Follow-Up

• Emphasize vaccination where appropriate (e.g., influenza, pneumococcal vaccines)
• Manage chronic conditions proactively (e.g., diabetes, COPD) to reduce infection risk
• Ensure close follow-up for patients recently treated for infections

Neftaly Clinic Sepsis Management Checklist

✅ Early identification using qSOFA or clinical judgment
✅ ABCDE assessment and stabilization
✅ Oxygen supplementation and fluid resuscitation as indicated
✅ Prompt referral for all suspected severe cases
✅ Clear documentation and communication
✅ Patient and caregiver education

Conclusion

Sepsis requires urgent action, and clinics are critical frontline settings for early recognition and intervention. Using Neftaly’s Acute Care Protocol, providers can improve timely management, ensure safe transfer, and ultimately save lives.