Complicated Gastroduodenal Perforation

Empiric Treatment:

Check one:

Mild-moderate

Those who do not meet criteria for severe infection but may have:

SIRS (two or more of: Temperature >38°C or <36°C; Heart rate >90/min; Respiratory rate >20/min; White blood cell count >12,000/mm3 or <4,000mm3)
Co-morbidities (e.g. diabetes, advanced age)
Significant pain

Severe

Requiring ICU admission, or

Sepsis (life-threatening organ dysfunction e.g. hypotension, acute renal failure, caused by dysregulated host response to infection)

Check one:

Community acquired (Most)

Acquired in the outpatient setting

Health care-associated (Rare)

Acquired more than 48 hours post admission without immediate repair, or

Hospitalization, surgery, regular outpatient visits (e.g. dialysis, chemotherapy) within last 90 days or residing in long term care