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Follow Mr. Peabody's case of suspected sepsis post-pneumonia, including vital signs, assessments, labs, interventions, and deteriorating condition.
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Sepsis TableTop Scenario Colorado Hospital Association
Clinical Scenario – Mr. Peabody • Mr. Peabody is a 67 year-old male who arrived by EMS from his primary care physician’s office where he was short of breath and suspected to have pneumonia. • PMH: current smoker for 50 years, COPD, 2L home oxygen, hypertension, right total hip replacement 10 weeks ago post fall.
Clinical Scenario – Mr. Peabody 1300 – Initial EMS Vital Signs • BP 136/70 • HR 100 sinus tach • RR 20 • Temp 99.5°F • SpO2 94% 2L NC Transport paramedic assessment: awake, alert and oriented. Decreased lung sounds at the left base. Productive cough, yellow thick sputum.
Clinical Scenario – Mr. Peabody 1315 – Transport Vitals • BP 105/62 • HR 100 sinus tach • RR 25 • Temp 101.7° F • SpO2 94% 4L NC
Clinical Scenario – Mr. Peabody 1330 – Arrival in Emergency Department • BP 86/42 • HR 125 sinus tach • RR 28 • Temp 101.3°F • SpO2 95% 4L NC Assessment: alert and oriented x3. Decreased lung sounds at the left base. Productive cough, yellow thick sputum. Right hip incision is pink and closed. Weight 85 kg.
Initial Labs (resulted at 1430) Drawn in triage
Clinical Scenario – Mr. Peabody 1500 – Completed Interventions • Fluids = 30 mL/kg at 1430 • Blood cultures at 1400 • Antibiotics at 1430 • Lactate level . . . to be repeated now • Tylenol at 1330
Clinical Scenario – Mr. Peabody 1500 – Latest Vitals • BP 98/55 • HR 125 sinus tach • RR 28 • Temp 100.4°F • SpO2 93% 4L NC
Clinical Scenario – Mr. Peabody 1515 – 15 Minutes Later • BP 94/45 • HR 130 sinus tach • RR 32 • Temp 100.4°F • SpO2 90% 4L NC POC lactate: 2.7