›Immediate actions
›Monitor
›Continuous pulse oximetry
›Cardiac monitoring if unstable
›IV access
›Two large bore IVs if sepsis concern
›Intraosseous access if no IV and unstable
›Oxygen
›Target oxygen saturation 94 percent or higher
›Escalate to noninvasive ventilation if increased work of breathing
›Sepsis bundle timing
›Broad spectrum antibiotics within 1 hour if sepsis or shock
›Lactate within 1 hour if unstable
Empiric antibiotics by syndrome
›Uterine source suspected
›Postpartum endometritis empiric coverage
›Clindamycin plus gentamicin
›Add ampicillin if enterococcus concern or no improvement
›Severe sepsis or polymicrobial concern
›Piperacillin tazobactam
›Consider vancomycin if MRSA risk
›Cesarean wound infection suspected
›Cellulitis without purulence
›Beta lactam coverage for streptococci and MSSA
›MRSA coverage if risk factors
›Purulent infection or abscess
›MRSA active agent plus gram negative and anaerobe coverage if deep infection concern
›Surgical evaluation for drainage
›Mastitis suspected
›Uncomplicated
›Dicloxacillin or cephalexin oral dosing per local protocol
›MRSA coverage if high local prevalence or prior MRSA
›Severe or systemic toxicity
›IV antibiotics and imaging for abscess
›Continue breastfeeding or pumping if tolerated
›Pyelonephritis suspected
›IV antibiotics per local resistance patterns
›Tailor to culture results
›Source control strategies
›Retained products suspected
›Obstetrics consult urgent
›Ultrasound correlation
›Abscess suspected
›Drainage planning
›Interventional radiology or surgery involvement
›Wound dehiscence or necrotizing concern
›Immediate surgical consult
›Do not delay debridement for imaging if unstable
›Resuscitation targets
›Crystalloid bolus 30 mL per kg for hypotension or lactate 4 mmol/L or higher
›Vasopressors if hypotension after fluids
›Norepinephrine first line
›Central access when feasible
Breastfeeding and medication safety
›Lactation considerations
›Continue breastfeeding or pumping in mastitis unless contraindicated
›Avoid breastfeeding interruption unless medication specific
›Discuss contrast and antibiotics compatibility local protocol dependent
›Reassessment schedule
›Recheck vitals every 15 to 30 minutes if unstable
›Repeat lactate within 2 to 4 hours if elevated
›Reexamine uterus and wound after analgesia and antibiotics
›Escalate imaging if persistent fever or rising lactate
›Consultation plan
›Obstetrics or gynecology early for uterine or pelvic sources
›Surgery for necrotizing infection or severe wound infection
›Infectious diseases for refractory sepsis or unusual pathogens
›Lactation support for mastitis and breastfeeding continuation