Sepsis Chaos - Competency Escape Game

ChaoticKitchen

Sepsis Escape Game

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

Click the steps in order to begin!

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Case Study

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

Evidence of cardiac dysfunction

2 or more SIRS criteria

1 or more sign(s) of acute organ dysfunction

Known or suspected infection

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

Click here when you find all 4 correct ingredients

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

(Hint: there are 4 total)

Respiratory Rate >20 or PaCO2 <32

Heart Rate >90 bpm

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

Temperature <96.8 or >100.9

pH <7.35

Lactate >2

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

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

ALT of 437 in a post cardiac arrest patient

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

False

True

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

Run in circles screaming "HELP!"

Check on the patient

Page the provider to tell them the patient is septic

Ignore it

Close...but no

Wrong

NO! Please don't do this

YES!

Next

Recipe to Survive Sepsis

Clue#1 = 73

Sepsis Identification

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Case Study

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

Incorrect

Correct

The list does not have to be in a specific order

Draw a CBC

Draw a Lactate Level

Blood Cultures x2

Blood Cultures x1

Arterial Blood Gas (ABG)

Broad Spectrum Antibiotics

30 mL/kg LR or NS IV Bolus*

2 L LR or NS IV Bolus*

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

Continue

solution

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

False

True

Recipe to Survive Sepsis

Sepsis Identification

Clue#2 = 77

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Case Study

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

Vasopressin

LR Bolus

Levophed

CBC

Lactate

Lactate

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

Select all that apply

Spinal Precautions

Has a known DVT in the leg

Below the knee amputee

Has SCDs ordered

Nope👎

Bingo!

Correct!

Yes!

Next

Which patient(s) below are fluid responsive?:

Select all that apply

After a PLR, SVI increases by 14%

After a PLR, the SVI decreases by 10%

After a bolus challenge, the SVI increases by 9.8%

After a bolus challenge, the SVI increases by 28%

No...

Yay! 👍

Nope👎

Next

Correct!

Recipe to Survive Sepsis

Sepsis Identification

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Clue#3 = 47

Case Study

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

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.:

Labs in the E.D.:

Next

Back

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?

No

Yes

Are you sure...?

RR- 31 & WBC- 14.2

Next

Back

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

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

Most recent vitals.:

No

Yes

Are you sure...?

No urine output

Next

Back

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?

No

Yes

Are you sure...?

Likely UTI

Next

Back

What interventions should be ordered and implemented immediately?

Select all that apply

Blood Cultures x2

Lactate Level

Weight-based IV Fluid Bolus

Antibiotics

Perfect!

Yay!

Not yet...

Next

Correct!

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

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?

Yes

No

What additional intervention should be ordered and implemented?

2 L LR IV Bolus

IV Bolus (LR or NS) 30 mL/kg

IV Bolus (LR ONLY) 30 mL/kg

Additional antibiotics

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 RA Is the patient in septic shock?

Yes

No

What additional interventions does the patient now require?

Select all that apply

Repeat Blood Cultures x2

Repeat Lactate Level

Re-evaluate fluid status

Vasopressors

Yasss!

You got it!

Yay!

Next

Nope

Is there a time limit for these additional intervetions?

Yes- 6 hours from sepsis presentation

Yes- 12 hours from sepsis presentation

It doesn't matter

No- just complete them when I have time

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

Norepinephrine

Vasopressin

Epinephrine

Phenylephrine

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

10:02 am Immediately after the IV bolus is finished

It doesn't matter

2:02 pm 4 hours after the IV bolus is given

4:02 pm6 hours after the IV bolus is given

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

Yes

It doesn't matter

Recipe to Survive Sepsis

Sepsis Identification

3 Hour Sepsis Bundle

6 Hour Sepsis Bundle

Case Study

Clue#4 = 65

Escape

Enter the code from the recipe to survive sepsis & escape this chaos!

Enter the code

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

Draw a CBC

Blood Cultures x1

Blood Cultures x2

Arterial Blood Gas (ABG)

Broad Spectrum Antibiotics

2 L LR or NS IV Bolus*

30 mL/kg LR or NS IV Bolus*

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