Resuscitation in Sepsis

Question 1

What is the Sepsis 6?

Answer 1

Take:
Blood cultures
Lactate
Measure urine output
Give:
Oxygen
Antibiotics
Fluids?

Question 2

Oxygen

Answer 2

Measure sats
94-98%
Measure ABGs

Question 3

IV Antibiotics

Answer 3

ASAP

Localise infection and prescibe accordingly

Question 4

IV Fluids

Answer 4

Fluid challenge - set volume over set time
250-500mls over 15 minutes (crystalloid 0.9%)
MAP >65mmHg
30ml/kg over first 3 hours
If lack of response in BP then consider transfer to MHDU

Question 5

Lactate

Answer 5

Measure
High = Hypoperfusion, assoc w/ high mortality
>4 then should be repeated at 4-6 hours

Question 6

Urine output

Answer 6

Marker of organ perfusion
Fluid balance should be commenced on admission
May require catheter
>0.5ml/kg

Question 7

Hours 2-6

Answer 7

Continue resus

Aim for improvement in NEWS, Haemodynamically stable and Reduction in lactate

Question 8

What is septic shock?

Answer 8

?

Question 9

What means a patient is deteriorating?

Answer 9

New confusion
Deteriorating NEWS
High RR
Low BP
Low BM

Question 10

ONgoing management?

Answer 10

Escalate to MHDU
Make a decision
Add Vasopressors if MAP <65mmHg