General: Sepsis

Question 1

Outline the pathophysiology of sepsis.

Answer 1

Life-threatening organ dysfunction caused by an abnormal and uncontrolled host response to an infection

Question 2

What are the risk factors of sepsis?

Answer 2

Extremes of age <1 or >75

Impaired immune system

Surgery or invasive procedure

Breech of skin = cuts, burns, blisters

IV drug use

Pregnancy or given birth

Miscarriage or termination in the last 6 weeks

Question 3

What are the signs and symptoms of sepsis?

Answer 3

No-blanching rash

Decreased urination

Altered mental state

Difficulty breathing

Chills

LOC

Question 4

How would you investigate sepsis?

Answer 4

SOFA score = quantify level of organ dysfunction (=>2 indicated sepsis)

BP = low

HR = high

RR = high

C+S

Lactate

Question 5

How would you manage sepsis?

Answer 5

Sepsis 6:

• Oxygen = 15L, non-rebreathe mask, aim for 94-98%
• IV fluid = 500-1000ml bolus
• Blood cultures = taken before Abx
• IV Abx = empirical, switching when sensitivities available
• Lactate = blood gas
• Urine output = catheterise, aim for >0.5ml/kg/hour

Identify the source

• Urine dip +/- C+S
• CXR
• Swabs of wound
• Operative site assessment
• LP
• Stool culture

Escalate management

Question 6

What are the complications of sepsis?

Answer 6

Mortality 30-40%

Shock = Requires vasopressors to maintain BP.