Assessment
• 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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