Exam 1: Sepsis (Liao) Flashcards
T/F Sepsis is a medical emergency
TRUE
early detection saves lives
T/F Sepsis this the MOST expensive hospital condition
TRUE
long lasting outcomes: high mortality and morbidity
Patients w/ ______ or _____ have worse outcomes b/c their body does not mount the immune response needed
low temp OR low white blood cell count
T/F Sepsis and Bacteremia are the same thing
FALSE; NOT
sepsis (body response to the infection)
starts w/ bacteria that triggers immune response–> increase in temp, EBC
histamine triggers–> iNOS that causes vasodilation–> capillaries and vessels LEAK–> hypotension
EARLY SEPSIS
Additional cytokines cause damage to endothelial cells–> trigger coagulation cascade–> pts risk for CLOTS and BLEEDING
LATE SEPSIS
ACT FAST W/ SEPSIS why
higher mortality associated w/ ICU care advanced age chronic obstructive disease immunosuppression multiple-organ dysfx wrong/late antibiotics late clinical presentation
Source of infection
obtain ______ blood cultures BEFORE antimicrobial therapy
at least 2 sets
obtain cx from other suspected sources
Identify a source and if it needs to be removed no more than ______ hours after diagnosis
6-12 hours
Types of source control (4)
- drainage
- debridement
- device removal
- definitive control (surgery)
Gram _____ are usually the source of SEPSIS (50%), but _____ are more likely to produce septic shock
POSTIVE; gram NEG
When do antibxs need to be administered for sepsis
ASAP
within the first hour
T/F early goal directed therapy
initial 6 hours is when fluids need to be given
no longer recommended
ProCESS(60-day) and ARISE (90day) trial
there was no difference in mortality if you followed the protocol or usual care to create sepsis
PROMISE
no difference in outcome if EGDT used within 6 hours
