Infection: Acute sepsis

Question 1

What is sepsis?

What is septic shock?

Answer 1

Sepsis is life threatening organ dysfunction due to an over-reaction of the host to infection.
Septic shock is worse, its persisting hypotension requiring treatment to maintain BP despite fluid resuscitation.

Question 2

How do we recognise sepsis?

Answer 2

Pt gets very unwell very quickly - look for red flags such as high RR, low BP, unresponstive etc
Look for a possible source eg UTI, pneumonia, meningitis

Question 3

What is the sepsis six?

Answer 3

6 things that need to be done within an hour:

1. Give oxygen
2. Blood culture - needs to be done before antibiotics
3. IV antibiotics - broad spectrum eg penicillins or aminoglycosides
4. Fluid resuscitation
5. Lactate
6. Measure urine output

Question 4

Why is the coagulation cascade initiated in sepsis?

Answer 4

Cytokines are produced which initiate production of thrombin, and also inhibit fibrinolysis.

The coag cascade can lead to microvascular thrombosis and therefore organ ischaemia and failure.

Question 5

What is the supportive treatment of acute sepsis?

Answer 5

The sepsis 6

Regular monitoring and reassessment