11: Summary of sepsis Flashcards
What is the first question you must answer before diagnosing sepsis?
Infection or not?
After deciding there is infection, what question should you ask?
Where is the infection that is causing sepsis
i.e which antibiotic man antibiotics do I choose
After you’ve confirmed the site of infection, a NEWS score of > __ says their response is excessive.
What are the corresponding qSOFA and SIRS scores?
NEWS > 5
qSOFA > 2
SIRS > 2
Which response must you give within 1 hour if you reckon a patient’s response to infection is excessive?
SEPSIS SIX
BUFALO
What are some special considerations when administering sepsis six?
COPD
Endocarditis (3 samples instead of 1)
Heart failure (be careful with fluids)
C. diff (oral vanc!)
loads of others
What are the steps in diagnosing infection?
HISTORY
EXAMINATION
INVESTIGATIONS - radiologym biochemistry, immunology, microbiology sampleS, PCR, molecular studies
What sorts of patients may have abnormal responses to infection?
cards for abnormal pathogens and abnormal sites
Younger/older
Pregnant
Immunosuppressed
Co-morbidities
What patient must be treated very differently from an acute care adult in terms of sepsis?
People presenting to GPs (e.g rural patients)
Pregnant women
Children
If a patient’s NEWS is 5 or more, think ___.
sepsis
What must you remember to do when taking blood for culture?
Take samples from all other relevant sites
How many cultures need to be taken in Sepsis 6?
One
(Three for endocarditis)
What must you do with pus?
Drain it
How are viruses e.g flu identified?
Viral PCR
What are the 4 Ds of antimicrobial therapy?
Dose
Duration
Dform
De-escalate
Which antibiotics can cause C. diff infection?
All of them
but the 4Cs in particular