5. Acute Sepsis Flashcards
What is the lay definition of sepsis?
Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs
What is the definition of septic shock?
Is a subset of sepsis where particularly profound circulatory, cellular and metabolic abnormalities substantially increase mortality
What are the steps of sepsis?
SIRS - systemic inflammatory response syndrome
Sepsis
Sever sepsis
Septic shock
Why is it important to have a definition of sepsis?
Improve communication between health professionals, and between healthcare and its patients
Use of language suitcase to educate unlicensed about condition
Establishment of criteria and thresholds beyond which intervention is recommended
What is sepsis?
Collection of physiological responses to infection
Characterised by inflammation
In sepsis, the reactions of the immune system to infection becomes dysregulated
What happens in sepsis?
Vasodilation
Capillary leakage - to get WBC out into tissues, then causes swelling
Amplification - upregulation of cytokines
How are the airways affected in sepsis?
No specific facet unless infection arises from throat or neck
Decreased consciousness may be at risk of airway problems
Lungs can fill with fluid
How is breathing affected in sepsis?
Raised respiratory rat (tachypnoea)
Fluids and proteins leaking into interstitial tissues lead to lung oedema and decreased lung compliance
Increased acid in blood, lots of breaths to remove CO2
How is circulation affected in sepsis?
Hypovolaemia due to vasodilation and capillary leakage leading to hypotension as systemic vascular resistance decreases
Tachycardia
End organ damage - hypoperfusion to kidneys
How does sepsis affect disability?
Reduced blood flow to brain
May present as confusion, drowsiness, slurred speech, agitation, anxiety or decreased level of consciousness
How can temperature be affected by sepsis?
High temperature due to hypothalamic response to infection
Beware hypothermia especially in elderly
How is especially at risk from sepsis?
Very young <1 year old
Elderly >75 years or very frail
Pregnant, postpartum (within last 6 weeks)
Patients with impaired immune system due to illness or drugs
How is sepsis diagnosed?
Think sepsis if the patient:
- is triggering an early warning score
- looks ill
- has any signs of infection
What does the national early warning score (NEWS2) rate?
Respiration rate Oxygen saturation Systolic blood pressure Pulse rate Level of consciousness or new confusion Temperature
Validates for use in non-pregnant adults (16+)
What does a NEWS 2 score show?
An elevated score does not provide a diagnosis
Helps to identify patients who need urgent clinical review
NEWS2 of 5 or more think sepsis
Clinical judgment is important
