READ ME / 1: Introduction to sepsis Flashcards
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The questions are written using the official Dundee lectures, so you might find it useful to have them open in the background in case you get stuck.
I write the questions based on what I think the important facts are, but not everything is relevant. Don’t waste your time learning tiny details.
On the other hand, this isn’t everything you need to know - back it up with stuff from tutorials, other people’s questions, Youtube videos, Oxford handbooks etc.
There’s a good chance that older decks will be inaccurate (lectures and guidelines change year to year) so I’ll try to update them in the future.
Break a leg 👍
What should be eliminated in any patient with an infection?
Sepsis
What does colonisation mean?
Microbe in the body WITHOUT an inflammatory response
e.g Staph aureus on the skin
What is infection?
Inflammatory response due to a microbe
What is bacteraemia?
Presence of viable bacteria in the blood
What is septicaemia?
A duff term that shouldn’t be used
What is the definition of sepsis?
Life-threatening organ dysfunction caused by dysregulated host response to infection
What is the definition of septic shock?
Circulatory / metabolic dysfunction secondary to sepsis
i.e the patient cannot be adequately resuscitated
___ is a subset of ___.
(sepsis, septic shock)
Septic shock is a subset of sepsis
People with septic shock have a much higher mortality and should be admitted to…
intensive care
Sepsis has distinct ___ and ___.
signs and symptoms
What is an abdominal infection caused by leakage of bowel contents into the peritoneal cavity?
Peritonitis
general signs and symptoms of sepsis
What needs to be determined re: sepsis to treat it properly?
Severity
How does sepsis cause organ dysfunction?
Bacteraemia causes leaky blood vessels
> ischaemia, infarction
What is SIRS?
Is it in favour anymore?
Systemic inflammatory response syndrome
No, NEWS or qSOFA criteria used now
Is SIRS specific to infection?
No, caused by trauma, pancreatitis…
But all patients with sepsis fulfill the SIRS criteria
Apart from infection, what are some other causes of SIRS?
Trauma (especially polytrauma)
Burns
Pancreatitis
What are the SIRS criteria?
T > 38 or < 36
HR > 90bpm due to leaky vessels > insufficient perfusion
RR > 20/min due to perceived hypoxia
Raised or reduced WBCs
With regard to SIRS criteria, what is sepsis?
2+ fulfilled SIRS criteria with KNOWN INFECTION
What is septic shock with regard to SIRS criteria?
2+ fulfilled SIRS criteria
Known infection
Organ dysfunction
Hypotension despite fluid resuscitation
As sepsis progresses to septic shock, mortality ___.
increases
How do you remember the Sepsis 6 bundle of treatment?
BUFALO
Give three, take three
(Take blood, urine output, lactate. Give fluids, oxygen and antibiotics.)
What is SOFA?
Sequential organ function assessment
A scoring system for sepsis
When is the actual SOFA score used?
ICU
when you have access to loads of information
What is the abbreviated version of the SOFA score?
qSOFA
What are the three criteria in the qSOFA score?
RR > 22/min
sBP < 100mgHg
Altered GCS
The higher your qSOFA score, the greater your ___.
mortality
qSOFA:
Respiratory rate > __ / min
sBP < ___ mmHg
GCS < __
RR > 20/min
sBP < 100 mmHg
GCS < 14
How does the NHS score patients at risk of sepsis?
NEWS2 score
A NEWS2 score of > __ and __ is diagnostic of sepsis.
NEWS2 > 5
confirmed infection
The higher your NEWS2 score, the poorer your ___.
prognosis
NEWS2 and ___ scoring tend to agree with one another.
qSOFA
