Inpatient Maternal Sepsis ToolTo be applied to all women who are pregnant or up to six weeks postpartum

(or after the end of pregnancy if pregnancy did not end in a birth) whohave a suspected infection or have clinical observations outside normal limits

Patient details (affix label): Staff member completing form:

Date (DD/MM/YY):

Name (print):

Designation:

Signature:

Tick N1. Has MOWS triggered (≥3)?

N4. Any Maternal Amber Flag criteria?

TickY

2. Could this be an infection?Tick

N

Y

3. Is ONE of the following maternal Red Flags present? Tick YResponds only to voice or pain/ unresponsive

Time complete InitialsSend bloods if 2 criteria present, consider if 1Systolic B.P ≤ 90 mmHg (or drop >40 from normal)

N Include lactate, FBC, U&Es, CRP, LFTs, clottingHeart rate > 130 per minute

Immediate call to doctor andRespiratory rate ≥ 25 per minute Shift Leader For review within 1hr

Needs oxygen to keep SpO2 ≥92% Time clinician/ Midwife attendedNon-blanching rash, mottled/ ashen/ cyanotic

Not passed urine in last 18 hoursIs AKI present? (tick) YES NOUrine output less than 0.5 ml/kg/hr

Lactate ≥2 mmol/l YTime complete Initials(note- lactate may be raised in & immediately after normal labour & delivery)

Y

Red Flag Sepsis!! Start Sepsis 6 pathway NOW (see overleaf)This is time critical, immediate action is required.

Sepsis Six and Red Flag Sepsis are copyright to and intellectual property of the UK Sepsis Trust, registered charity no. 1158843. Sepsistrust.orgPage 1

Sepsis Six PathwayTo be applied to all women who are pregnant or up to six weeks postpartum(or after the end of pregnancy if pregnancy did not end in a birth) who have

a suspected infection or have clinical observations outside normal limits

Consultant informed?Time zero (tick) InitialsInform Consultant Obstetrician & Obstetric Anaesthetist;

OR consider transfer to Obstetric Unit. State patient has Red Flag Sepsis

Action (complete ALL within 1 hour) Reason not done/variance

Time complete1. Administer oxygen

Initials

Time complete2. Take blood cultures

Initials

Time complete3. Give IV antibiotics

Initials

Time complete4. Give IV fluids

Initials

Time complete5. Check serial lactatesNot applicable- initial lactate

Initials

Time complete6. Measure urine output

Initials

If after delivering the Sepsis Six, patient still has:• systolic B.P <90 mmHg• reduced level of consciousness despite resuscitation• respiratory rate over 25 breaths per minute• lactate not reducingOr if patient is clearly critically ill at any time

Then call Critical Care Outreach immediately!!

Sepsis Six and Red Flag Sepsis are copyright to and intellectual property of the UK Sepsis Trust, registered charity no. 1158843. Sepsistrust.orgPage 2