Managment

Question 1

What are general interventions in sepsis management

Answer 1

• Transfer to ER to ICU ASAP
• ECG monitoring
• Pulse oximetry
• Arterial catheter
• Frequent blood sampling
• Assessment of arterial pressure
• Lactate levels:Adequacy of tissue perfusion & anaerobic glycolysis, Lactate levels >4 mmol/L = increased risk of death

Question 2

How and when should ABX be initiated

Answer 2

Within 1 hour
Broad spectrum, narrow later when you have a identified organism

Question 3

What BG level should they be maintained at

Answer 3

80-110

Question 4

What is the CVP, SVO2, and MAP levels that indicate adequate resuscitation

Answer 4

CVP 8-12 mm Hg
• SV02 >70%
• MAP > 65 mm Hg

Question 5

How much rapid crystaloids should be administered

Answer 5

30mls/kg

Question 6

S/s of hypoperfusion

Answer 6

Oliguria
• Encephalopathy
• Poor capillary refill
• Metabolic acidosis

Question 7

What is the current recommendation for sepsis vasopressor use

Answer 7

Norepinephrine then epinephrine then vasopressin 5

Question 8

Tidal volume, PaO2/FiO2 ratio and plateau pressure recommendations for ARDS

Answer 8

Recommended target tidal volume
• 6 mL/kg predicted body weight with ARDS
Upper limit goal for plateau pressures
• 30 cm H20 over higher plateau pressures
Recommended for PaO2/Fi02 ratio <150