Kaiser Sepsis Calculator

The Kaiser Permanente Sepsis Early Warning System (SEWS) is a clinical alert tool developed by Kaiser Permanente to help identify hospitalized patients at risk for sepsis before they deteriorate. It uses automated EMR (electronic medical record) screening of vital signs and clinical indicators to trigger early notification to nursing and medical staff. The system has been shown to reduce sepsis mortality in Kaiser Permanente facilities through earlier intervention.

SIRS (Systemic Inflammatory Response Syndrome) criteria require 2 or more of: (1) Temperature >38°C (100.4°F) or <36°C (96.8°F); (2) Heart rate >90 bpm; (3) Respiratory rate >20 breaths/min or PaCO2 <32 mmHg; (4) White blood cell count >12,000/mm³ or <4,000/mm³ or >10% bands. Sepsis is defined as SIRS with a suspected or confirmed source of infection. However, the 2016 Sepsis-3 guidelines moved away from SIRS toward organ dysfunction-based criteria.

Under the 2016 Sepsis-3 definitions: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection, defined as a SOFA score increase of 2 or more points. Septic shock is a subset of sepsis with severe circulatory, cellular, and metabolic dysfunction — defined as requiring vasopressors to maintain MAP ≥65 mmHg and having serum lactate >2 mmol/L despite adequate fluid resuscitation. The older term "severe sepsis" is no longer used under Sepsis-3 guidelines.

Vital sign abnormalities that may indicate sepsis include: temperature above 100.4°F (38°C) or below 96.8°F (36°C); heart rate above 90 bpm; respiratory rate above 20 breaths/minute; systolic blood pressure below 90 mmHg or MAP below 65 mmHg; oxygen saturation below 95% on room air; and new or worsening altered mental status. The presence of these abnormalities in a patient with suspected infection requires urgent clinical assessment.

The Surviving Sepsis Campaign guidelines recommend administering broad-spectrum IV antibiotics within one hour of sepsis recognition, particularly for septic shock. The CMS SEP-1 core measure requires antibiotics within 3 hours of sepsis presentation. Early antibiotic administration is associated with significantly reduced mortality — studies show each hour of delay in antibiotics increases mortality by approximately 7% in septic shock. Blood cultures should be obtained before antibiotics if this does not cause significant delay.

qSOFA (Quick Sequential Organ Failure Assessment) is a bedside sepsis screening tool introduced in Sepsis-3 that uses 3 criteria: altered mental status (GCS <15), respiratory rate ≥22/min, and systolic BP ≤100 mmHg. A score of 2 or more suggests organ dysfunction and poor outcomes. Unlike SIRS (which can be triggered by non-infectious causes and is no longer in the sepsis definition), qSOFA specifically targets organ dysfunction. qSOFA is simpler than the full SOFA score and requires no lab results.

No — this calculator is an educational reference tool only and cannot diagnose sepsis. Sepsis diagnosis requires comprehensive clinical assessment by qualified healthcare professionals including physical examination, laboratory results (lactate, blood cultures, CBC, metabolic panel), imaging, and clinical judgment. This tool is intended to help healthcare students, nurses, and clinicians understand the screening criteria used in the Kaiser Permanente early warning system — it is not a validated clinical decision support tool.

The Surviving Sepsis Campaign Hour-1 Bundle includes: measuring lactate level (remeasure if >2 mmol/L); obtaining blood cultures before antibiotics; administering broad-spectrum antibiotics; beginning 30 mL/kg crystalloid IV fluid for hypotension or lactate ≥4 mmol/L; and applying vasopressors if hypotension persists to maintain MAP ≥65 mmHg. Source control (draining abscess, removing infected catheter) is also critical. ICU admission is required for septic shock.