Use this quick-reference guide to recognise, treat and hand over Sepsis & Septic Shock on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Suspect
Infection + confusion
Fast breathing · low BP
Fever not required
✅ Treat
Access + fluids
Recheck lungs
Pressors if still low
📌 Alert
Early sepsis notification
Low ETCO2 = poor perfusion
📚 Sepsis & Septic Shock — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Sepsis is a dysregulated response to infection that causes organ dysfunction, and septic shock is sepsis with persistent hypotension and poor perfusion. EMS impact comes from recognizing it early, starting fluids, and alerting the receiving facility so antibiotics are not delayed.
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Key points
Understand these first
Suspect sepsis with a known or suspected infection plus altered mentation, fast breathing or low blood pressure.
Fever is not required — older adults and immunocompromised patients may be normal or cold.
Low end-tidal CO2 in suspected infection suggests poor perfusion and elevated lactate.
Early crystalloid fluids are indicated for hypotension or poor perfusion; reassess lungs between boluses.
Vasopressors are for hypotension that persists after adequate fluid resuscitation.
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Treatment priorities
What to do, in order
Notify the receiving facility early with a sepsis alert.
Obtain vascular access and start fluids for hypotension or signs of poor perfusion.
Check glucose and support oxygenation; watch for crackles during fluid resuscitation.
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Red flags — report now
Escalate immediately
Hypotension persisting after fluids
New confusion with infection
Mottled skin or very low end-tidal CO2
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Patient teaching
What patients must know
Warm, flushed skin can occur early in septic shock because the vessels dilate — do not let warm skin reassure you.
❓ Sepsis & Septic Shock: NREMT FAQs
What are the priority actions for Sepsis & Septic Shock in the field?
Notify the receiving facility early with a sepsis alert. Obtain vascular access and start fluids for hypotension or signs of poor perfusion. Check glucose and support oxygenation; watch for crackles during fluid resuscitation.
What findings in Sepsis & Septic Shock change your plan or your transport decision?
Hypotension persisting after fluids. New confusion with infection. Mottled skin or very low end-tidal CO2.
What do I need to know about Sepsis & Septic Shock for the NREMT?
Suspect sepsis with a known or suspected infection plus altered mentation, fast breathing or low blood pressure. Fever is not required — older adults and immunocompromised patients may be normal or cold. Low end-tidal CO2 in suspected infection suggests poor perfusion and elevated lactate. Early crystalloid fluids are indicated for hypotension or poor perfusion; reassess lungs between boluses.
What should the crew communicate or document for Sepsis & Septic Shock?
Warm, flushed skin can occur early in septic shock because the vessels dilate — do not let warm skin reassure you.
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Quick Tip
Suspect sepsis with a known or suspected infection plus altered mentation, fast breathing or low blood pressure.