HYHO Sepsis Flashcards
What are the four types of shock?
cardiogenic
hypovolemic
distributive
obstructive
What organ systems are involved in SOFA? Why might qSOFA be preffered?
respiration, coagulation, liver, CV, renal, CNS
SOFA requires lab data, but qSOFA can be done at bedside
sepsis suspected if either score > 2
What is septic shock?
sepsis with persisting hypotension requiring vasopressors to maintain MAP ≥ 65 mmHg and having a serum lactate > 2 mmol/L despite adequate volume resuscitation
Sepsis algorithm (they said to memorize)
What is seen in all types of shock?
hypotension
tachycardia
altered mental state
oliguria
What labs should be ordered in sepsis?
CMP
CBC with diff
PT, PTT, Fibrinogen, D-dimer, peripheral blood smear
ABG
Serum lactate
Plasma procalitonin
id source of infection
What hematological disorder is a fear in septic pts?
DIC
clotting and bleeding
labs show: thrombocytopenia, inc PT/PTT/d-dimer/FDPs, dec fibrinogen levels, abnormal peripheral blood smear
What are some serious complications of sepsis?
DIC
AKI
Acute hepatic injury
ARDS
What is needed for ARDS dx?
PaO2:FiO2 < 300 mmHg
In order to maintain a good vascular access you need to…
insert 2 large bore peripheral IVs
central line (right internal jugular vein catheter)
arterial line
urinary catheter
possibly endotracheal intubation
What is recommended within the first hour of sepsis diagnosis?
measure lactate levels
obtain blood cultures
give broad spectrum ABs
fluid resuscitation
vasopressors
What are the clinically important vasopressor receptors?
alpha 1
beta 1
beta 2
D1
V1
V2
What are the Chapman’s points for thel ungs, liver, GI, and kidney?
Autonomic innervation heart, liver, lungs, kidney
5 model of care: Sepsis
