• Search for localising symptoms or signs of infection.

• Full clinical examination noting BP, pulse, mouth, chest, perineum, line sites, skin and fundi.

• O2 saturation (pulse oximetry).

• FBC, U&E, creatinine, LFTs, CRP, INR, APTT, fibrinogen.

• Perform a septic screen:

- 3 sets of blood cultures (10mL per bottle optimises organism recovery) if central line present, take paired peripheral and central samples.

- Single further blood culture set if non-response at 48-72h or condition changes.

• Swab relevant sites: wounds, central line exit site, throat.

• Faeces if symptomatic incl. C difficile toxin.

• Viral serology if clinically relevant.

• Other imaging as relevant, consider sinus x-ray.

• Consider bronchoalveolar lavage if chest infiltrates present.

• Consider risk of invasive fungal infection: CT chest if high risk.

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