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Table 1 NICE Risk of severe illness or death from sepsis

From: Derivation and internal validation of the screening to enhance prehospital identification of sepsis (SEPSIS) score in adults on arrival at the emergency department

Category High risk criteria Moderate to high risk criteria Low risk criteria
History Objective evidence of new altered mental state History from patient, friend or relative of new onset of altered behaviour or mental state
History of acute deterioration of functional ability
Impaired immune system (illness or drugs including oral steroids)
Trauma, surgery or invasive procedures in the last 6 weeks
Normal behaviour
Respiratory Raised respiratory rate: 25 breaths per minute or more
New need for oxygen (more than 40% FiO2) to maintain saturation more than 92% (or more than 88% in known chronic obstructive pulmonary disease)
Raised respiratory rate: 21–24 breaths per minute No high risk or moderate to high risk criteria met
Blood pressure Systolic blood pressure 90 mmHg or less or systolic blood pressure more than 40 mmHg below normal Systolic blood pressure 91–100 mmHg No high risk or moderate to high risk criteria met
Circulation and hydration Raised heart rate: more than 130 beats per minute Not passed urine in previous 18 h.
For catheterised patients, passed less than 0.5 ml/kg of urine per hour
Raised heart rate: 91–130 beats per minute (for pregnant women 100–130 beats per minute) or new onset arrhythmia
Not passed urine in the past 12–18 h
For catheterised patients, passed 0.5–1 ml/kg of urine per hour
No high risk or moderate to high risk criteria met
Temperature   Tympanic temperature less than 36 °C  
Skin Mottled or ashen appearance Cyanosis of skin, lips or tongue Non-blanching rash of skin Signs of potential infection, including redness, swelling or discharge at surgical site or breakdown of wound No non-blanching rash