Sepsis

Question 1

What is sepsis?

Answer 1

Defined as organ dysfunction, hypoperfusion or hypotension.

Question 2

What is septic shock?

Answer 2

Profound circulatory, cellular, and metabolic deterioration.

Question 3

What happens in sepsis?

Answer 3

• Immune system activation leading to release of many cytokines, as well as NO. NO leads to vasodilation and increased capillary permeability
• The endothelium is activated leading to increased permeability and subsequent oedema
• These processes lead to hypotension and shock
• There is also raised blood viscosity reducing perfusion

Question 4

What are the signs and symptoms of sepsis?

Answer 4

• Slurred speech
• Extreme shivering (rigors) or muscle pain
• Passing no urine
• SOB
• ‘I feel like I might die’
• Skin mottled or discoloured – cyanosis

Question 5

How should sepsis be managed?

Answer 5

• SEPSIS SIX – three out and three in
• BLOOD CULTURES immediately before antibiotic commencement. Must take at least two samples from different sites
• OTHER BLOODS: lactate
• URINE OUTPUT
• HIGH-FLOW OXYGEN
• IV ANTIBIOTICS
• FLUID CHALLENGE