Overview of Sepsis ands Infection (1)

Question 1

what 2 things have to occur for sepsis to occur?

Answer 1

SIRS

Infection (identifiable infectious agent)

Question 2

SIRS?

Answer 2

systemic inflammatory response syndrome

Question 2

infectious agents causing SIRS?

Answer 2

bacteria

fungi

parasites

viruses

Question 3

other causes of SIRS other than infectious agents? (non-infected cause)

Answer 3

Trauma pts

burns

pancreatitis

Question 4

is sepsis a syndrome?

Answer 4

not an individual illness, a syndrome, a combination of things

SIRS and infection

Question 5

Ways to quantify pt susceptible to sepsis?

Answer 5

SIRS

qSOFA

NEWS

Question 6

what is SIRS?

Answer 6

2 OR MORE OF THESE PARAMENTERS

1. fever: over 38 or under 36 dc
2. heart rate over 90 bpm
3. respiratory rate over 20 breaths per minute
4. WBC count: over 12,000/uL or under 4000/uL

Question 7

in spesis, does neutrophil count increase or decrease?

Answer 7

increased

Question 8

severe sepsis?

Answer 8

SIRS and infective case with hypotension or evidence of organ hypoerfusion (e.g. decreased urine output, confusion)

life threatening

Question 9

who may not have SIRS response?

Answer 9

extremes of age and immunosuppressed

Question 10

most recent sepsis definition?

Answer 10

a life-threatening organ dysfunction due to a dysregulated host response to infection

• 2016

Question 11

qSOFA aka?

Answer 11

quick sepsis related organ failure assessment

Question 12

How does qSOFA score sepsis?

Answer 12

• Modified (quick) SOFA score
• 1 point assigned for each of:

1) GCS (Glasgow coma scale - confusion)<15

2) RR ≥22 breaths per min

3) SBP ≤100mmHg

• The presence of 2 or more qSOFA points near the onset of infection was
  associated with a greater risk of death or prolonged intensive care unit stay

Question 13

What score is used in grampain?

Answer 13

NEWS

National early warning score

Question 14

How does NEWS score sepsis?

Answer 14

1. Respiration rate.
2. Oxygen saturation.
3. Systolic blood pressure.
4. Pulse rate.
5. GCS / new confusion.
6. Temperature.

adds in pulse rate, oxygen saturation, and temp

Question 15

Why is sepsis important?

Answer 15

• People die of untreated/mistreated infections.
• Mortality of sepsis around 30%.
• Worldwide accounts for more deaths than breast or colon cancer.
• Important to recognise symptoms and treat early.
• Sepsis 6 bundle: (O2, BC, IV abx, lactate, IV fluid, urine output).
• Early empiric antibiotics (within 1 h) associated with improved response.

Question 16

What to remember about the NEWS score?

Answer 16

objective system to identify pts at risk of sepsis

Question 17

sepsis 6 bundle to manage sepsis pt?

Answer 17

O2

BC

IV abx (best guess abx) - within the hour, improved response

lactate (high lactate = severe sepsis)

IV fluid (help raise blood pressure)

urine output (reduce urine output indicate reduced kidney function)