3.2 Acute Sepsis in A&E Flashcards
Define sepsis
A life-threatening organ dysfunction due to a dysregulated host response to infection
What happens in sepsis
Vasodilation
Capillary leakage
Amplification
ABCDE of sepsis
Airways
Breathing
Circulation
Disability
Exposure
Who is at risk of sepsis
Very young (<1 yr)
Elderly (>75 yrs)
Pregnant women, postpartum (within last 6 weeks)
Patients with impaired immune system due to illness/drugs
When do you screen for sepsis
NEWS2 score is >5
Patient. Is at risk of neutropenia
Evidence of organ dysfunction (e.g.2mmol/l)
What are the 6 physiological measurements for NEWS2
Respiration rate
Oxygen saturation
Systolic BP
Pulse rate
Lv. consciousness/new confusion
Temperature
What is Red Flag Sepsis
Not at formal diagnosis
High risk of deterioration
What is the amber flag sepsis
Further review required
Criteria:
What is Sepsis 6
A set of six tasks that has been shows to greatly increase the patient’s chance of survival if delivered within the 1 hr following recognition of sepsis
Each hr delay in giving antibiotic increases mortality by what percentage
7.6%
List the components of Sepsis 6
Senior help
Give oxygen if required
Send bloods including cultures
Give IV antibiotic & consider source control
Consider IV fluids
Monitor
How do you test for organ failure
Urine
Liver function test
Treatment & Prevention for sepsis
Antibiotics (ceftriaxone)
Vaccination (men B, men C, men ACWY)
Prophylaxis for close contacts
Meningitis
Indicators for Red flag sepsis
NEWS2 (>7)
Or
NEWS2 (5/6) and
-lactate (>2mmol/L)
-chemotherapy in last 6 weeks
-other organ failure evident
-actively deteriorating
Indicators for Amber flag sepsis
NEWS2 (5/6)
Or
NEWS2 (1-4), one of
-lactate (>2mmol/L)
-chemotherapy in last 6 weeks
-other organ failure
-looks extremely unwell
-actively deteriorating
