I: Acute Sepsis Flashcards
What is sepsis?
Life-threatening organ dysfunction due to dysregulated host response to infection.
What is bacteraemia?
Presence of bacteria in the blood
What clinical assessment is used to recognise sepsis?
EWS (early warning score)
Above 3, a patient should be considered for sepsis.
What is sepsis 6 bundle?
The core of the sepsis improvement efforts. Using “bundles” simplifies the complex processes of the care of patients with severe sepsis.
e. g.
1. Oxygen
2. Blood cultures
3. IV antibiotics
4. Fluid challenge
5. Lactate
6. Measure urine output
What are the features of acute sepsis?
- High resp rate
- Low bp
- Tachycardia
How do microorgaisms trigger the inflammatory cascade?
- Endotoxin binds to macrophages
- This leads to local release of cytokines (tissue necrosis factors and interleukins)
- These can be released into circulation resulting in systemic inflammation
- If this infection isn’t controlled this can lead to sepsis
What is the function of the polysaccharide capsule of a pathogenic microorganism?
- Promotes adherence
- Prevents phagocytosis
How do cytokines cause coagulation?
- Initiate production of thrombin
- Inhibit fibrinolysis
(This leads to microvascular thrombosis and hence organ ischemia leading to dysfunction and failure)
Name a specific type of treatment related to sepsis.
Antimicrobials
Name a supportive type of treatment relating to sepsis.
Physiological restoration: SEPSIS SIX Resuscitation or IV fluids to raise BP
Describe features of Neisseria meningitides.
- Gram negative
- Diplococcus
- Numerous serogroups (A, B, C, W-135)
- Outer membrane acts as endotoxin
Describe features of meningococcal disease.
- Up to 25% of adults may be carrier
- Spread by aerosols and nasopharyngeal secretions
- Can be cleared, carried or invaded
- Fatality rate 10%
- In England cases are mainly group B
How does Neisseria meningitides evade the immune response by preventing phagocytosis?
Presence of polysaccharide capsular antigen.
