Basic principles

Question 1

Colonisation

Answer 1

the presence of a microbe in the human body without an inflammatory response

Question 2

Infection

Answer 2

inflammation due to a microbe

Question 3

Bacteraemia

Answer 3

Presence of viable bacteria in the blood

Question 4

Sepsis

Answer 4

the dysregulated host response to infection

Question 5

Septic shock

Answer 5

Sepsis and both of:
-Persistent hypotension (requiring vasopressors to maintain MAP > or = 65mmHg)

AND

-Lactate > or = 2mmol/l

DESPITE ADEQUATE FLUID RESUS

Question 6

order of disease continuum?

Answer 6

1. SIRS
2. Sepsis
3. Septic shock
4. Death

Question 7

what is SIRS?

Answer 7

Systemic inflammatory reponse syndrome

Non specific clinical response including 2 or more of:
▪ Temp >38 or <36
▪ HR >90bpm
▪ RR >20bpm
▪ WCC >12000 or <4000 or >10% immature neutrophils

Cause: trauma, burns, infection, pancreatitis and other

Question 8

what is sepsis? (disease continuum)

Answer 8

SIRS with presumed or confirmed infection

SIRS:
Non specific clinical response including 2 or more of:
▪ Temp >38 or <36
▪ HR >90bpm
▪ RR >20bpm
▪ WCC >12000 or <4000 or >10% immature neutrophils

Question 9

what is septic shock (disease continnum)?

Answer 9

Sepsis with evidence of organ dysfucntion

Sepsis plus at least one acute organ dysfunction:
* Renal
* Resp
* Hepatic
* Haematological e.g. DIC
* CNS
* Unexplained matabolic acidosis
Cardiovascular hypotension

despite fluid resus

Question 10

what scoring system is used for sepsis?

Answer 10

NEWS score

Question 11

when should sepsis be considered - NEWS score?

Answer 11

News of 5 or more + known infection or signs + symptoms of infection or at risk of infection consider sepsis

Question 12

what scoring system is used to screen for outcomes of sepsis?

Answer 12

qSOFA