Burn Sepsis Screening (ABA 2007) — free guideline decision tool

This tool screens for burn sepsis using the American Burn Association 2007 consensus triggers, since severe burns produce a baseline systemic inflammatory state that makes standard SIRS/sepsis criteria unreliable.

Six triggers (temperature, progressive tachycardia, progressive tachypnea, thrombocytopenia after ≥ 3 days, hyperglycemia, enteral feeding intolerance). Sepsis = ≥ 3 triggers AND confirmed/suspected infection.

Use in the burn ICU to flag possible sepsis: ≥ 3 of the 6 triggers together with a confirmed or suspected infection prompts a sepsis workup and treatment.

Because post-burn hypermetabolism mimics SIRS, the ABA created burn-specific triggers rather than relying on generic sepsis criteria; the final call remains a prospective team decision. (original synthesis · not guideline verbatim) Thrombocytopenia is counted only after ≥ 3 days of resuscitation, when early dilutional changes have settled. The triggers correlate only modestly with bacteremia, so a positive screen prompts a source search rather than confirming infection.

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Inputs: Temperature > 39°C or < 36.5°C No, Progressive tachycardia > 110 bpm No, Progressive tachypnea (non-ventilated > 25/min or ventilated minute ventilation > 12 L/min) No, Platelets < 100,000/µL (after ≥ 3 days of resuscitation) No, Hyperglycemia (non-diabetic: untreated glucose > 200 mg/dL or insulin ≥ 7 U/h or > 25%/24h increase in requirement) No, Enteral feeding intolerance > 24 h (distension/residual 2× feeding rate/diarrhea > 2500 mL/d) No, Confirmed or suspected infection present No → Result: Triggers met 0/6（Decision: < 3 triggers, continue monitoring, beware that post-burn hypermetabolism can mask infection, Note: Severe burns are themselves a systemic inflammatory state, so traditional SIRS/sepsis criteria are unreliable; the ABA therefore created burn-specific triggers. This standard correlates only modestly with bacteremia, so the final judgment is a prospective clinical decision by the burn team, Basis: Greenhalgh DG, et al. ABA Consensus to Define Sepsis and Infection in Burns. J Burn Care Res 2007） Inputs: Temperature > 39°C or < 36.5°C Yes, Progressive tachycardia > 110 bpm Yes, Progressive tachypnea (non-ventilated > 25/min or ventilated minute ventilation > 12 L/min) Yes, Platelets < 100,000/µL (after ≥ 3 days of resuscitation) Yes, Hyperglycemia (non-diabetic: untreated glucose > 200 mg/dL or insulin ≥ 7 U/h or > 25%/24h increase in requirement) Yes, Enteral feeding intolerance > 24 h (distension/residual 2× feeding rate/diarrhea > 2500 mL/d) Yes, Confirmed or suspected infection present Yes → Result: Triggers met 6/6（Decision: ≥ 3 triggers AND confirmed/suspected infection → meets ABA burn sepsis; start sepsis workup and treatment (find the source, obtain cultures, empiric antimicrobials, resuscitation), Note: Severe burns are themselves a systemic inflammatory state, so traditional SIRS/sepsis criteria are unreliable; the ABA therefore created burn-specific triggers. This standard correlates only modestly with bacteremia, so the final judgment is a prospective clinical decision by the burn team, Basis: Greenhalgh DG, et al. ABA Consensus to Define Sepsis and Infection in Burns. J Burn Care Res 2007）