Hey all, I'm a relatively new ICU nurse and had a few questions regarding sepsis as I see these patients often. I know the SIRS criteria are low/high temp, low/high WBCs, tachycardia and tachypnea but what would cause the low temps/low WBCs vs. high temps/high WBCs? Also, what causes the ionized calcium to be so low in these patients? Finally, our sepsis protocol includes drawing a baseline cortisol level and starting IV steroids - how exactly does adrenal insufficiency play in? I have looked into my critical care texts but haven't found any straightforward answers. Thanks to all in advance!