Emergency bedside toolkit

☣️ SEPSIS-TSH WEBAPP

Sepsis screening, infusion support, ABG interpretation, and ID tools in one app.

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Clinical Decision Support

Designed for fast bedside reading with clear visual priority for risk, escalation, and treatment support.

Screen

Use SIRS, SOS, NEWS2, qSOFA, and shock index together.

Stabilize

Move fast to fluids, antibiotics, vasopressors, and escalation.

Support

Open ABG, antibiogram, renal dosing, and THAI-LEPTO as needed.

Body Temperature (°C) : Heart Rate (/min) : Respiratory Rate (/min) : SBP (mmHg) : SpO₂ (%) : NEWS2 SpO₂ Scale : Use Scale 2 only after blood-gas confirmation and a documented decision by a competent clinical decision maker. Receiving Supplemental Oxygen ? WBC (/mm³) : Urine Output (mL/hr) : Conscious Level :

Essential inputs Blood gas + chemistry

pH Required PaCO₂ Required · mmHg Blood-gas HCO₃⁻ Required · mEq/L Serum total CO₂ For AG · mEq/L Na⁺ For AG · mEq/L Cl⁻ For AG · mEq/L Albumin Corrected AG · g/dL

Sample & compensation contextType, timing and respiratory durationOptional

Sample type Gas collection time Chemistry time Respiratory duration

OxygenationDevice, FiO₂, PaO₂, SpO₂ and PEEPOptional

Oxygen device FiO₂ (%) PaO₂ (mmHg) SpO₂ (%) PEEP / CPAP (cmH₂O) (optional)

Lactate & clinical contextTrend, shock, hypoperfusion and AKIOptional

Initial lactate (mmol/L) Initial lactate time Repeat lactate (mmol/L) Repeat lactate time Clinician-confirmed septic shock Hypoperfusion-induced lactic acidemia AKI status Increased work of breathing / fatigue New altered mental status

Advanced AG settingsPotassium and local reference limitAdvanced

K⁺ (mEq/L) (optional) Local AG upper reference limit Include K⁺ in AG formula Confirm a matching local reference range

Results update automatically when pH, PaCO₂ and HCO₃⁻ are complete.

Bedside interpretation guideFive practical steps · formulas · limitations

1

Check the sample first

Confirm ABG, VBG or capillary sample and collection time.
Use blood-gas HCO₃⁻ for acid–base consistency; use chemistry total CO₂ for anion gap.
If values or sample times disagree, verify the specimen before interpreting.

2

Identify the primary pattern

pH	PaCO₂	HCO₃⁻	Likely primary pattern
↓	↑	—	Respiratory acidosis
↓	—	↓	Metabolic acidosis
↑	↓	—	Respiratory alkalosis
↑	—	↑	Metabolic alkalosis

A near-normal pH does not exclude a mixed disorder.

3

Check expected compensation

Metabolic acidosisExpected PaCO₂ = 1.5 × HCO₃⁻ + 8 ± 2

Other disorders

Use the disorder-specific acute or chronic compensation range shown in the patient result.

If measured compensation is outside the expected range, consider an additional acid–base process.

4

Interpret the anion gap

Standard AGNa − (Cl + chemistry total CO₂)

Albumin-corrected AGAG + 2.5 × (4 − albumin)

Compare with the entered local upper reference limit.
Do not calculate corrected AG when albumin is missing.
Use delta ratio only when AG is elevated and chemistry total CO₂ is reduced; it is supportive, not diagnostic.

5

Apply clinical context and safety limits

Review perfusion, lactate trend, renal function, respiratory effort and mental status.
P/F and S/F are supportive; they do not establish ARDS without timing, imaging and respiratory-support criteria.
PaCO₂ alone is not an indication for intubation.
Sodium bicarbonate is never an automatic order from this calculator.

SSC 2026 bicarbonate contextSuggest against bicarbonate solely to improve hemodynamics or reduce vasopressors in hypoperfusion-induced lactic acidemia. Conditional consideration applies to septic shock with pH ≤ 7.2 and AKI stage 2–3.

Clinical referencesMerck Manual—compensation table Surviving Sepsis Campaign 2026

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