6.5 Sepsis + SOFA Flashcards
Q5 — Sepsis, qSOFA and sepsis bundles
a) Define sepsis and septic shock.
● Sepsis — life-threatening organ dysfunction
caused by a dysregulated host response to infection.
● Septic shock — a subset of sepsis in which the underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality.
b) What are the features of RED FLAG sepsis?
● Responds only to voice or pain or unresponsive.
● Acute confusional state.
● Systolic BP <90mmHg or drop >40mmHg from normal.
● Heart rate >130 per minute.
● Respiratory rate >25 per minute.
● Needing oxygen to keep SpO2 >92%.
● Non-blanching rash, mottled/ashen/cyanotic.
● Anuric in the last 18 hours.
● Urine output less than 0.5ml/kg/hr.
● Lactate >2mmol/L.
● Recent chemotherapy.
c) What are the criteria of the qSOFA (quick SOFA) score?
● Respiratory rate >22/min.
● Altered mentation.
● Systolic blood pressure <100mmHg.
d) How is the qSOFA score useful?
● Quick, rapid bedside assessment.
● Prompts further investigations for organ dysfunction.
● Useful to initiate/escalate care as appropriate.
● Prompts to increase the frequency of
monitoring or referral to critical care.
● A qSOFA score >2 predicts increased mortality.
e) List the elements of sepsis bundle interventions.
● Measure lactate level (repeat if initial lactate >2mmol/L).
● Obtain blood cultures before the administration of antibiotics.
● Administer broad-spectrum antibiotics.
● Begin rapid administration of 30ml/kg crystalloid for hypotension or lactate >4mmol/L.
● Apply vasopressors if hypotensive or after fluid resuscitation to
maintain MAP >65mm Hg.
An hour-1 bundle is a group of interventions, all of which should begin in the first hour from sepsis recognition but may not be necessarily completed within the first hour
