Suspected Sepsis: New Update for NICE Guideline NG51

4 April, 2024

The updated NICE guideline NG51 covers the recognition, diagnosis and early management of suspected sepsis.

It includes recommendations on recognition and early assessment, initial treatment, escalating care, finding and controlling the source of infection, early monitoring, information and support, and training and education.

Sepsis, a life-threatening condition triggered by the body’s overwhelming response to infection, demands swift recognition and early intervention to save lives. In the pursuit of enhancing patient care, the National Institute for Health and Care Excellence (NICE) continually updates its guidelines to reflect the latest evidence and best practices. The recent update to NICE guideline NG51 focuses on the recognition, diagnosis, and early management of suspected sepsis, aiming to bolster healthcare professionals’ ability to identify and treat this critical condition promptly. Let’s explore the key changes and an overview of the updated guidelines’ core principles.

Overview of NICE Guideline NG51

NICE guideline NG51, originally published in 2016, serves as a vital resource for healthcare professionals involved in the care of individuals with suspected sepsis. It provides comprehensive recommendations for recognising, diagnosing, and initiating early management of sepsis across all healthcare settings, aiming to improve patient outcomes and reduce mortality rates associated with this condition.

Key Changes in the Updated Guideline

The updated NICE guideline NG51 brings several significant changes and additions to enhance the recognition and management of suspected sepsis. Here are the key updates:

Enhanced Clinical Suspicion

Recognising the critical importance of early recognition, the updated guideline emphasises the need for healthcare professionals to maintain a high index of suspicion for sepsis, particularly in individuals presenting with signs or symptoms of infection. This includes promptly assessing patients for indicators of systemic inflammatory response syndrome (SIRS) and other clinical markers suggestive of sepsis.

Revised Criteria for Sepsis and Septic Shock

The updated guideline provides revised criteria for the diagnosis of sepsis and septic shock, aligning with the latest evidence and international consensus definitions. Healthcare professionals are guided to consider clinical parameters such as altered mental status, respiratory rate, and elevated lactate levels in identifying patients with sepsis and determining the severity of their condition.

Early Recognition Tools and Risk Stratification

To facilitate timely identification of sepsis, the updated guideline recommends the use of validated early recognition tools and risk stratification algorithms. These tools help healthcare professionals assess the likelihood of sepsis in patients presenting with infection-related symptoms and guide the appropriate escalation of care based on individual risk profiles.

Streamlined Diagnostic Pathways

In recognition of the need for streamlined diagnostic pathways, the updated guideline offers clear recommendations for conducting rapid investigations to confirm the presence of infection and assess the severity of sepsis. This includes prompt blood culture collection, imaging studies, and laboratory tests to guide targeted antimicrobial therapy and supportive interventions.

Early Management Strategies

Emphasising the importance of early intervention, the updated guideline provides evidence-based recommendations for the initial management of suspected sepsis, including the timely administration of broad-spectrum antibiotics, fluid resuscitation, and haemodynamic support as needed. Healthcare professionals are encouraged to initiate appropriate interventions promptly, even in the absence of definitive diagnostic confirmation, to optimise patient outcomes.


The updated NICE guideline NG51 represents a significant advancement in the recognition, diagnosis, and early management of suspected sepsis, reflecting a commitment to improving patient care and reducing mortality associated with this life-threatening condition. By emphasising enhanced clinical suspicion, revised diagnostic criteria, utilisation of early recognition tools, streamlined diagnostic pathways, and early management strategies, the updated guideline equips healthcare professionals with essential guidance to identify and treat sepsis promptly and effectively. Embracing these updates promises to enhance sepsis care outcomes and ultimately save lives.

Access the full guidance

Read through some of our other resources here: Ashtons Resources – Improving quality and compliance in medicines management