Clinical Emergency Response System (CERS)

The SEPSIS KILLS program is built on the foundations of the Between the Flags (BTF) system. It is intrinsically linked with the 'track and trigger' NSW standard Observation Charts and Clinical Emergency Response Systems (CERS).

Deteriorating patients with sepsis can be escalated via the Standard Observation Charts and the CERS. By undertaking routine clinical observations, nurses and doctors play a vital role in identifying and escalating sepsis. The clinician is encouraged to think why the patient is deteriorating and ask "could this be sepsis?"

Preliminary NSW sepsis data suggests that 30 per cent of adults that require a Rapid Response are septic. This is replicated in national and international literature1 with sepsis being a leading cause for clinical deterioration, accounting for one in three calls for a Rapid Response team.

The tools provided by the BTF system and SEPSIS KILLS program give clinicians objective criteria, backed by policy for escalation, which empowers them to call for senior clinical help when they judge a patient to be deteriorating or are concerned about the patient's condition. This is illustrated in the following diagram:

Improving the Recognition and Management of Severe Infection and Sepsis

More information can be found on the Between the Flags web page.

Jones D, Duke G, Green J et al. Medical Emergency Team syndromes and an approach to their management. [cited 2014, March 31] Available from: