Resuscitation in Sepsis Flashcards
Why is prompt delivery of antibiotics for sepsis so important?
7.6% increase in mortality with every hour antibiotics are delayed
What is sepsis?
Evidence of infection plus evidence of organ dysfunction = serious complication of infection with associated high mortality
What can sepsis progress to?
Rapidly progresses to multi-organ failure and septic shock due to overwhelming host response
When would you consider diagnosing sepsis?
NEWS >= 5 plus evidence of infection
What is septic shock?
Evidence of sepsis plus hypotension despite fluid resuscitation and vasopressors with lactate >2
What are some risk factors for sepsis?
Age <1 or >70, immunosuppression, pregnancy, neonates
What are the sepsis 6?
Measure urine output and lactate
Give IV fluids and antibiotics
Deliver oxygen and take bloods for culture
What are the target oxygen saturations for a patient with sepsis?
94-98% = use non-rebreather mask if acutely unwell and measure ABG if concerned
How many sets of cultures are needed for sepsis?
At least one set
What are the most common sources of sepsis?
Pneumonia and UTI
How much fluids are prescribed?
Prescribe 250-500ml over 15 minutes
What are the aims of fluid resuscitation in sepsis?
Aim for MAP >65mmHg and to deliver 30ml/kg over the first 3 hours
What types of fluids are first choice for resuscitation?
Crystalloids = 0.9% saline or Hartmann’s
What does high lactate indicate?
Hypoperfusion
When should lactate be remeasured if the initial measurement is >4?
In 4-6 hours
