Acute Sepsis

Question 1

Define Sepsis

Answer 1

Life-threatening organ dysfunction due to dysregulated host response to infection

Question 2

Define Septic Shock

Answer 2

Persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation

Question 3

How does Sepsis affect;

1. Airways
2. Breathing
3. Circulation
4. Disability (3 ways it can present)
5. Exposure

Answer 3

1. None unless infection in throat/ neck (Decreased consciousness may affect airways)
2. Tachypnoea. Exudate leaking leads to lung oedema and decreased lung compliance
3. Hypovolaemia + hypotension, Tachycardia, End organ damage
4. Reduced blood flow to brain. ( Confusion/ Drowsiness/ Slurred speech)
5. High temperature. (Hypothermia in elderly)

Question 4

Identify 6 signs of sepsis

Answer 4

SEPSIS

Slurred speech or confusion
Extreme shivering or muscle pain
Passing no urine in a day
Severe breathlessness 
It feels like you’re going to die
Skin mottled or discoloured

Question 5

Name 4 groups of people especially at risk

Answer 5

• Very young (< 1 year old)
• Elderly (>75 years)
• Pregnant/ Post Partum
• Immuno compromised

Question 6

Identify 5 red flags of sepsis

Answer 6

Acute Confusion
Respiratory rate >/= 25 per min
HR> 130 per min
Systolic pressure = 90mmHg
Non-blanching rash

Question 7

What is the Sepsis bundle

Answer 7

Give:

• Oxygen
• Antibiotics
• Fluid challenge

Take:

• Blood cultures
• Hb and measure Lactate
• Measure urine output

Question 8

Name 6 Supportive investigations and 3 specific investigations for Sepsis

Answer 8

Supportive:

• FBC, Urea, Electrolytes
• Blood sugar
• Liver function tests
• CRP
• Coagulation studies
• Blood gases

Specific:

• CSF
• Throat swab
• PCR

Question 9

How can sepsis be diagnosed in 3 ways

How will CSF appear

Answer 9

• Blood culture
• Blood PCR
• Microscopy, Culture, PCR of CSF
• Turbid and coloured