RAPID Sepsis Assessment

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The RAPID Sepsis Assessment guidelines below are used at UCSF Benioff Children's Hospital Oakland and are provided only as a reference. They are based on the International Pediatric Sepsis Consensus Conference: Definitions for sepsis and organ dysfunction in pediatrics Pediatric Critical Care Medicine, 2005 Vol. 6, No. 1.

Step 1

Two of the following (one must be TEMP or WBC)

  • Temp: > 38.5 or < 36
  • WBC: see table below
  • RR: see table below
  • HR: see table below

If Yes = SIRS (Systemic Inflammatory Response Syndrome)

Step 2

Infection suspected?

If Yes = Sepsis

Step 3

End organ dysfunction?

  • Lethargy/irritability/altered mental status (not just "cranky") or
  • Poor perfusion (CRT > 3 secs) or
  • Decreased urine output (< 0.5 ml/kg/hr) or
  • Any bilateral infiltrates on CXR + need for oxygen

If Yes = Severe sepsis

  • Call MD (attending physician or PICU attending or fellow) immediately
  • Consider sending labs and starting severe sepsis guideline

Step 4

Hypotension?

If Yes = Severe shock

  • Start severe sepsis guideline immediately
Age Group Tachycardia Bradycardia Respiratory Rate WBC Systolic BP
0 day – 1 wk > 180 < 100 > 50 > 34 < 65
1 wk – 1mo
 > 180 < 100 > 40 > 19.5 or < 5 < 75
1 mo – 24 mo
 > 180 < 90 > 34 > 17.5 or < 5 < 100
2 – 5 yrs
 > 140 n/a > 22 > 15.5 or < 6 < 94
6 – 12 yrs
 > 130 n/a > 18 > 13.5 or < 4.5 < 105
13 – < 18 yrs
 > 110 n/a > 14 > 11 or < 4.5 < 117

UCSF Benioff Children's Hospitals medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child's provider.

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