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Sepsis Escape Game

ChaoticKitchen

start

Sepsis can be a recipe for disaster if all the correct ingredients aren't used, and if they are not used in the correct order...Click the arrow to begin. Look around the kitchen to find a recipe with the steps to help you survive sepsis. Once you have the recipe, correctly answer the questions in each step to get the numbers of the code to escape!

Look around the kitchen to find a recipe with the steps to help you survive sepsis.

Recipe to Survive Sepsis

Sepsis Identification

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Case Study

Click the steps in order to begin!

Which of the following is NOT a required component of a sepsis diagnosis

1 or more sign(s) of acute organ dysfunction

2 or more SIRS criteria

Evidence of cardiac dysfunction

Known or suspected infection

Move (drag) items around the counter space to find all the correct "ingredients" that are the SIRS criteria.

Once you find a correct "ingredient", click on it!

(Hint: there are 4 total)

Heart Rate >90 bpm

Respiratory Rate >20 or PaCO2 <32

Temperature <96.8 or >100.9

Lactate >2

pH <7.35

WBC <4 or >12, or >10% neutrophil bands

Click here when you find all 4 correct ingredients

Which of the following does not qualify as a sign of ACUTE organ dysfunction?

ALT of 437 in a post cardiac arrest patient

Creatinine of 4.2 in a hemodialysis patient

Blood pressure of 84/53 in a patient with myocarditis

Lactate level of 4.2 in a patient with pneumonia

True or False?Direct care nurses do not need to worry about Sepsis Alerts because the STAT Nurse is monitoring the alerts.

True

False

What is the first action you should take when you receive a sepsis alert on your patient?

Ignore it

Run in circles screaming "HELP!"

Check on the patient

Page the provider to tell them the patient is septic

YES!

NO! Please don't do this

Wrong

Close...but no

Next

Recipe to Survive Sepsis

Sepsis Identification

Code for this section: 73

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Case Study

Clue#1 = 73

Code for this section: 73

Sort (drag) the 3-Hour Sepsis Bundle Interventions into the correct list

Correct

Incorrect

Click "Solution" after sorting the lists to check your answer

Draw a Lactate Level

30 mL/kg LR or NS IV Bolus*

Broad Spectrum Antibiotics

Arterial Blood Gas (ABG)

2 L LR or NS IV Bolus*

Blood Cultures x1

Blood Cultures x2

solution

Draw a CBC

Continue

The list does not have to be in a specific order

*If hypotensive &/or elevated lactate

*If hypotensive &/or elevated lactate

It doesn't matter at all the order you complete any of the 3-hour bundle components in.

True

False

Recipe to Survive Sepsis

Sepsis Identification

Clue #1 = 73

3 Hour Sepsis Bundle

Code for this section: 77

6 Hour Sepsis Bundle

Case Study

Clue#2 = 77

Code for this section: 77

Select the red button below the group that has the correct 6-hour bundle components

Lactate

Levophed

LR Bolus

CBC

Lactate

Vasopressin

Passive Leg Raise to Evaluate Fluid Status

Passive Leg Raise to Evaluate Fluid Status

Echocardiogram to Evaluate Fluid Status

Repeat CBC

Levophed as first line for persistent hypotension

Repeat Lactate Level

Vasopressin as first line for persistent hypotension

Repeat Lactate Level

LR Bolus for Persistent Hypotension

Select which patient(s) below that a PLR would be contraindicated in:

Spinal Precautions

Below the knee amputee

Has a known DVT in the leg

Has SCDs ordered

Correct!

Yes!

Nope👎

Bingo!

Select all that apply

Next

Which patient(s) below are fluid responsive?:

After a PLR, SVI increases by 14%

After a PLR, the SVI decreases by 10%

After a bolus challenge, the SVI increases by 28%

After a bolus challenge, the SVI increases by 9.8%

Correct!

No...

Yay! 👍

Nope👎

Next

Select all that apply

Recipe to Survive Sepsis

Sepsis Identification

Clue #1 = 73

3 Hour Sepsis Bundle

Clue #2 = 77

6 Hour Sepsis Bundle

Code for this section: 47

Case Study

Clue#3 = 47

Clue #1 = 73

Clue #2 = 77

Code for this section: 47

You are working in a C.C. unit and get an admission from the E.D.

Next

The 74 y.o. female pt was admitted with altered mental status, agitation, and weakness. She was admitted to your unit for management of a dexmedetomidine infusion for her agitation due to having allergies to lorazepam and alprazolam.

Vital signs in the E.D.:

Back

Labs in the E.D.:

2 hours after arriving to your unit, the pt begins to complain of flank pain and is frequently setting off her bed alarm attempting to get out of bed, insistent that she needs to urinate. She has not voided since prior to arrival in the ED

Most recent vitals.:

Does the patient have any SIRS criteria present?

Back

Are you sure...?

Yes

No

RR- 31 & WBC- 14.2

Next

2 hours after arriving to your unit, the pt begins to complain of flank pain and is frequently setting of her bed alarm attempting to get out of bed, insistent that she needs to urinate. She has not voided since prior to arrival in the ED

Most recent vitals.:

Does the patient have any s/s of acute organ dysnfunction?

Are you sure...?

Back

Yes

No

No urine output

Next

2 hours after arriving to your unit, the pt begins to complain of flank pain and is frequently setting of her bed alarm attempting to get out of bed, insistent that she needs to urinate. She has not voided since prior to arrival in the ED.

Most recent vitals.:

Does the patient have a known or suspected infection?

Back

Are you sure...?

Yes

No

Likely UTI

Next

What interventions should be ordered and implemented immediately?

Blood Cultures x2

Lactate Level

Antibiotics

Weight-based IV Fluid Bolus

Correct!

Perfect!

Yay!

Not yet...

Next

Select all that apply

The physician orders a lactate level, blood cultures, & broad spectrum antibiotics.

Yes

No

You initiate ceftriaxone IV after the blood cultures are drawn. .

The pt's initial lactate level result comes back as 4.2 mmol/L

Are there any additional interventions to implement at this time?

What additional intervention should be ordered and implemented?

2 L LR IV Bolus

IV Bolus (LR or NS) 30 mL/kg

Additional antibiotics

IV Bolus (LR ONLY) 30 mL/kg

The patient's weight is 60 kg so at 10:02 am you administer a bolus of 1800 mL of LR as ordered by the provider.At 11:00 am the patient's VS are: HR-102, BP-79/42, SPO2- 89% on RAIs the patient in septic shock?

Yes

No

What additional interventions does the patient now require?

Repeat Blood Cultures x2

Repeat Lactate Level

Vasopressors

Re-evaluate fluid status

Nope

Yasss!

You got it!

Select all that apply

Yay!

Next

Is there a time limit for these additional intervetions?

Yes- 6 hours from sepsis presentation

No- just complete them when I have time

Yes- 12 hours from sepsis presentation

It doesn't matter

Which vasopressor should be initiated for this pt's persistent hypotension?

Norepinephrine

Vasopressin

Phenylephrine

Epinephrine

When should you perform a passive leg raise (PLR) to re-evaluate the patient's fluid status?

4:02 pm6 hours after the IV bolus is given

10:02 am Immediately after the IV bolus is finished

2:02 pm4 hours after the IV bolus is given

It doesn't matter

12:02 pm 2 hours after the IV bolus is given

You perform a PLR with the NICOM and recieve the results below:Is the patient fluid responsive?

No

It doesn't matter

Yes

Recipe to Survive Sepsis

Sepsis Identification

Clue #1 = 73

3 Hour Sepsis Bundle

Clue #2 = 77

6 Hour Sepsis Bundle

Clue #3 = 47

Case Study

Code for this section: 65

Escape

Clue#4 = 65

Clue #1 = 73

Clue #2 = 77

Clue #3 = 47

Code for this section: 65

starT over?

Congrats Chef!

You helped your patient escape sepsis!

To complete the competency, finish the HealthStream quiz using the code you just entered!

*Please be a good sport & don't share the code with your friends*

Print the HealthStream course completion certificate to show to a unit competency validator.

I'm asking super nicely ya'll...

Wrong!

Try Again!

Try Again!

Moira's Enchiladas Recipe

  • Tortillas
  • Chicken
  • Enchilada Sauce
  • Cheese
  • Patience

  1. Shred chicken & place into bowl
  2. Fold in the cheese
  3. Roll mixture up in tortillas
  4. Place enchiladas in baking dish
  5. Cover with sauce and more cheese
  6. Bake

Wrong Recipe!

Try again

Try again!

The answer is: "False"!

The STAT Nurse does not review or investigate Sepsis alerts on critical care patients.

You should always review the sepsis alert for accuracy and to be sure there hasn't been a change in your patient's condition

Draw a Lactate Level

30 mL/kg LR or NS IV Bolus*

Broad Spectrum Antibiotics

Arterial Blood Gas (ABG)

2 L LR or NS IV Bolus*

Blood Cultures x1

Blood Cultures x2

Draw a CBC

The answer is: "False"!

The STAT Nurse does not review or investigate Sepsis alerts on critical care patients.

You should always review the sepsis alert for accuracy and to be sure there hasn't been a change in your patient's condition