2. Red flags — a structured look

Think ABCDE first

Airway threat from floor-of-mouth or neck swelling is an emergency even before you label it sepsis. Stridor, unable to swallow saliva, sitting bolt upright, or a rapidly expanding neck needs 999 — not a private script and a review on Monday.

Red-flag style features (plain language)

Use current NICE / UK Sepsis Trust-style prompts rather than memorising a 2016 card. Typical high-concern features include: mottled or ashen skin; cyanosis; not passing urine; severe breathlessness; a new confusion or slurred speech; a very high or very low temperature; a very fast heart rate or very low blood pressure if you can measure them; and someone who will not wake or stay awake. Children have age-specific signs — if you are not confident, escalate early.

Concerning but not “wait and see”

Fever with spreading swelling, rigors, vomiting, severe pain out of proportion, or a person who “is not themselves” still needs same-day senior clinical review or urgent care — not a message on the answerphone after Friday lunch.

Do not rely on one number

A normal temperature does not exclude sepsis, especially in older or immunosuppressed people. Absence of a thermometer reading is not reassurance.

Document what you saw

Time, appearance, swelling extent, mouth opening, temperature if taken, advice, and who you called. If they decline emergency care, that is a capacity and safety-net problem — be clear, record it, and involve a senior.