Inpatient Maternal Sepsis Tool To be applied to all women who are pregnant or up to six weeks postpartum (or after the end of pregnancy if pregnancy did not end in a birth) who have a suspected infection or have clinical observations outside normal limits Patient details (affix label): Staff member completing form: Date (DD/MM/YY): Name (print): Designation: Signature: Tick N 1. Has MOWS triggered (≥3)? N 4. Any Maternal Amber Flag criteria? Tick Y 2. Could this be an infection? Tick N Y 3. Is ONE of the following maternal Red Flags present? Tick Y Responds only to voice or pain/ unresponsive Time complete Initials Send bloods if 2 criteria present, consider if 1 Systolic B.P ≤ 90 mmHg (or drop >40 from normal) N Include lactate, FBC, U&Es, CRP, LFTs, clotting Heart rate > 130 per minute Immediate call to doctor and Respiratory rate ≥ 25 per minute Shift Leader For review within 1hr Needs oxygen to keep SpO 2 ≥92% Time clinician/ Midwife attended Non-blanching rash, mottled/ ashen/ cyanotic Not passed urine in last 18 hours Is AKI present? (tick) YES NO Urine output less than 0.5 ml/kg/hr Lactate ≥2 mmol/l Y Time complete Initials (note- lactate may be raised in & immediately after normal labour & delivery) Y Red Flag Sepsis!! Start Sepsis 6 pathway NOW (see overleaf) This is time critical, immediate action is required. Sepsis Six and Red Flag Sepsis are copyright to and intellectual property of the UK Sepsis Trust, registered charity no. 1158843. Sepsistrust.org Page 1