0300. Night shift. You are the new grad.
Mrs. Brooks, 72, admitted for a UTI. Was chatting at 2100. Now confused, pulling at her lines.
UAP: "She's just sundowning."
◀ All casesCase 1 of 8
Case 1 · Sepsis screen
The Quiet Change
Bedside monitorLive
HR114
RR26
T38.7°C
BP92/56
What do you do?
Answer: C) Call rapid response NOW
Call rapid response / provider NOW, per your sepsis protocol.
WHY: New confusion + RR 26 + SBP 92 = 3/3 qSOFA. Add fever & HR 114 and that's a positive sepsis screen.
"Sundowning" is a diagnosis of exclusion. Waiting an hour is how septic shock gets a head start.
RememberSpeak up. Use SBAR. Escalate.