A “Code Sepsis” announcement in an emergency room signifies a hospital-wide medical alert. It mobilizes a specialized team to a patient’s bedside to address a potential case of sepsis, a life-threatening condition. This protocol is not a diagnosis itself, but the activation of a time-sensitive process for rapid, coordinated care. The system ensures that personnel and resources are immediately available to begin treatment.
Understanding Sepsis
Sepsis is the body’s extreme response to an infection. The primary injury is not caused by the infection, but by the body’s own dysregulated immune reaction. This widespread inflammatory response can trigger a cascade of changes, leading to tissue damage and organ failure. Common sources for the initial infection include pneumonia, urinary tract infections, or skin and abdominal infections.
The condition can progress rapidly, making early treatment important. As the body’s systems begin to fail, blood pressure can drop, and organs may not receive adequate blood flow, a state known as septic shock. The speed at which sepsis develops is why hospitals implement alerts like “Code Sepsis” to ensure a suspected case is treated with urgency.
The Sepsis Alert in the ER
Emergency department staff activate a “Code Sepsis” based on clinical signs that suggest a patient may be septic. This identification is guided by a checklist, and the presence of two or more signs prompts the alert. The primary indicators involve a patient’s vital signs and mental state.
Clinicians assess for specific criteria, including:
- A high fever or an unusually low body temperature (hypothermia)
- An elevated heart rate (tachycardia)
- A rapid respiratory rate
- A significant drop in blood pressure (hypotension)
- A sudden change in mental status, such as new confusion or extreme drowsiness
Immediate Medical Response
Once a “Code Sepsis” is called, a “sepsis bundle” of time-sensitive interventions begins immediately. The first step involves drawing blood for laboratory tests, including blood cultures to identify the infection’s cause and a lactate level test. An elevated lactate indicates that tissues are not receiving enough oxygen.
Simultaneously, medical staff work to control the infection. Broad-spectrum antibiotics are administered intravenously as quickly as possible. These are given without waiting for blood culture results, because delays in administration are associated with higher mortality rates.
Rapid fluid resuscitation is another component of the initial response. Patients with sepsis often have low blood pressure because their blood vessels have dilated. To counteract this, large volumes of intravenous (IV) fluids are given quickly to increase blood volume, raise blood pressure, and improve blood flow to vital organs.
Diagnostic and Monitoring Procedures
While immediate treatments are underway, the medical team performs diagnostic and monitoring procedures to gather more information. These actions help pinpoint the source of the infection and assess the patient’s response to treatment. This involves ongoing monitoring of vital signs, including heart rate, blood pressure, respiratory rate, and blood oxygen levels, and follow-up blood tests to track lactate levels and check for organ dysfunction. To locate the specific site of the infection, imaging studies are ordered, such as a chest X-ray for pneumonia or a CT scan for an abscess.
Transition to Advanced Care
After initial stabilization in the emergency department, the patient is transitioned to the next level of hospital care. Many patients will be admitted to a general hospital floor for continued IV antibiotics, monitoring, and supportive care.
For patients who remain critically ill or show signs of organ failure, a transfer to the Intensive Care Unit (ICU) is necessary. In the ICU, a specialized critical care team can provide a higher level of support. This may include medications to maintain blood pressure, mechanical ventilation to assist breathing, or dialysis to support failing kidneys.