3/2/17 Septic Shock HARRIS TEST #2 Flashcards
What are the four criteria you look for in systemic inflammatory response? (SIRS) (you have to have at least two of these if sepsis is considered)
- Temperature
- Heart Rate
- Respiratory Rate
- WBC
If you have an inflammatory response to microorganisms or the invasion of normally sterile tissues what do you have?
-Infection
If you have a systemic response to a variety of processes what might you have?
-SIRS
If you have an infection plus 2 SIRS criteria what might you have?
-Sepsis
If you have sepsis with organ dysfunction what might you have?
-Sever sepsis
If you have sepsis with hypotension despite fluid resuscitation what might you have?
-Septic shock
Who can get sepsis?
-Anyone
T/F Sepsis is most often present with pre-existing diseases such as cirrhosis, malignancy, AIDS, COPD, diabetes, and cancer therapy.
True
What gram species historically was more common at causing sepsis?
-Gram -
What gram species between 1979-2000 in the US at causing sepsis?
-Gram +
Today worldwide what is the most common gram species at causing sepsis?
-Gram -
What is Hypotension in blood pressure readings?
< 90 mmHg systolic
When you think of the differential diagnosis of shock/hypotension what other things do you have to take into consideration?
- Endocrine
- Neurogenic, anaphylactic
- Drugs, distributive
- Septic
- Hypovolemia
- Overdose, obstruction
- Cardiogenic
- Kills
What is sepsis?
-Clinical syndrome that results from a dysregulated inflammatory response to infection
If a patient has continued hypotension after a fluid bolus (usually 10-30 ml/kg) what could that be a sign of?
-Septic shock
What is hypotension often associated with?
-Organ damage or dysfunction
What is primary organ dysfunction?
-Result of a well-define insult (renal failure from muscle breakdown products)
What is secondary organ dysfunction?
-Not due to infection itself, but due to the host’s response (possibly a dysregulation of the innate immune system)
What are three mechanisms of tissue injury?
- Ischemia
- Cytopathic injury
- Increased apoptosis
What type of tissue injury mechanisms is when inflammatory mediators cause damage (direct and indirect)?
-Cytopathic injury
What is ischemia?
-Decreased O2 given tissue needs
What does PIRO stand for?
- Predisposition
- Insult
- Response
- Organ Dysfunction
When you treat Sepsis what should you do for a prophylaxis?
- ICU prophylaxis
- Nutrition
- PT
What is the goal in the treatment of sepsis?
-Restore tissue perfusion
What are three things to do in the 6 hour resuscitation bundle of sepsis?
- Early identification
- Early antibiotics and cultures
- Early goal directed therapy
What is the historic survival if the lactate is > 10?
< 10%
T/F When someone has Sepsis it is extremely important to monitor tissue perfusion
True
If your body temperature is above what it may be an indication of sepsis
101 F
If your body temperature below what it may be an indication of sepsis?
-96.8 F
