34.2 Sepsis Six Bundle Card — ASF Tool ASF-TOOL-EWD-02
Six actions in sixty minutes — recognise, call, act. Sepsis kills in hours; delays kill in minutes
What it is
A one-page action card for the Sepsis Six bundle — the six time-critical interventions that must be completed within one hour of recognising sepsis. Based on the Surviving Sepsis Campaign guidelines. This card includes the recognition criteria (qSOFA), the six mandatory actions, the one-hour documentation record, and the escalation trigger. Sepsis is a medical emergency: a one-hour delay in antibiotics increases mortality by 7% per hour.
ASF criterion
Evidence for: Hospital Standard 4, criterion 4.26 (Non-Negotiable) — Sepsis Is Recognised and Treated Within the Hour.
Step 1 — Recognise (qSOFA screen)
| SUSPECT SEPSIS if 2 or more of the following are present in a patient with suspected infection: | |
|---|---|
| Respiratory rate ≥ 22 breaths/min | ☐ Present |
| Altered mental state (new confusion or reduced GCS) | ☐ Present |
| Systolic BP ≤ 100 mmHg | ☐ Present |
| 2 or more present → CALL SENIOR DOCTOR NOW and start the Sepsis Six below | |
Step 2 — Act: The Sepsis Six (all within 60 minutes)
| # | Action | Time done | Done by |
|---|---|---|---|
| 1 | Give oxygen — target SpO2 ≥94% (88–92% in COPD) | ||
| 2 | Take blood cultures — before antibiotics; two sets if possible | ||
| 3 | Give IV antibiotics — as per local protocol; first dose NOW | ||
| 4 | Give IV fluid resuscitation — 500 ml crystalloid over 15 min if hypotensive or lactate ≥2 | ||
| 5 | Check lactate and full blood count — lactate >2 mmol/L = septic shock risk | ||
| 6 | Measure urine output — catheterise if needed; target ≥0.5 ml/kg/hour | ||
| Time sepsis recognised: | |||
| All six actions complete by: | |||
| Senior doctor name and time notified: | |||
The most common mistake
Giving antibiotics before taking blood cultures, or taking blood cultures but then waiting for results before giving antibiotics. The sequence is: cultures first, antibiotics immediately after — within minutes, not hours. The Monitor checks the timestamps.
ASF-TOOL-EWD-02 · Toolkit 34 — Early Warning & Deterioration · france-asf.fr/tools · Adapted from Surviving Sepsis Campaign guidelines (Singer et al., 2016) and UK Sepsis Trust Sepsis Six · ASF layout CC BY-NC-SA 4.0 · Antibiotic choices must be confirmed against national/local protocols · Keep this line on all adapted versions
