Table 1.

Rules for septic shock sniffer algorithm

Variable	Rule*	Modifier (time frame)
(Domain 1) Suspicion of infection
Microbiology culture order	Blood OR stool OR lavage OR urine OR sputum	In past 72 h
(Domain 2) Systemic inflammatory response (two of the following)
Temperature	>38.6°C or <35.0°C	In past 12 h
Heart rate	>90 beats/min	Four consecutive readings
Respiratory rate	>21 breaths/min	Four consecutive readings
White cell count	>13 000 cells/ml or <4000 cells/ml	In past 12 h
(Domain 3) Hypotension or hypoperfusion (one of the following)
Systemic mean blood pressure	<70 mm Hg	Four consecutive readings
Lactate	>3 mmol/l	In past 12 h
Base	<−4 mmol/l	In past 12 h
Anion gap	>13 mmol/l	In past 12 h
Use of vasoactive medications†	Dopamine OR norepinephrine OR epinephrine OR vasopressin OR dobutamine OR milrinone	In past 12 h

^*Alert triggered by a combination of all three domains.

^†Added 4 months after sniffer implementation.