Sepsis

Question 1

What is sepsis?

Answer 1

Life-threatening organ dysfunction caused by a dysregulated host response to infection.

Question 2

What is septic shock?

Answer 2

Sepsis plus either lactate >2 or requiring vasopressors to maintain >65mmHg.

Question 3

What is the SOFA score?

Answer 3

Sequential organ failure assessment score (sepsis):

1. Low PaO2
2. Low GCS
3. Hypotension
4. High bilirubin
5. Low platelets
6. High creatinine/oliguria

Question 4

What is the qSOFA Score?

Answer 4

Quick sequential organ failure assessment score (sepsis):

1. Low GCS
2. Resp rate >22
3. Systolic BP <100

Question 5

What are the signs and symptoms of sepsis?

Answer 5

1. Slurred speech/confusion
2. Extreme shivering or muscle pain
3. Passing no urine in a day
4. Severe breathlessness
5. If feels like you’re going to die
6. Skin mottled or discoloured

Question 6

What are the risk factors for developing sepsis?

Answer 6

Host genetics, extremities of age, immunosuppression, epidemic, DM, cancer, catheters, alcohol abuse.

Question 7

How is suspected sepsis investigated?

Answer 7

1. FBC
2. CRP -take >6hr to rise
3. Procalcitonin takes >2hr to rise
4. U&Es - raised creatinine
5. LFTs/coagulation - raised INR, aPTT
6. Hourly urine output

Question 8

What is the management for sepsis?

Answer 8

Sepsis 6:

1. Give oxygen
2. Give fluids (500ml challenge, senior help if 1L and no improvement)
3. Give Broad spectrum antibiotics
4. Take lactate
5. Take blood/urine cultures
6. Take urine output

Question 9

What is the main haematological complication of sepsis?

Answer 9

Disseminated intravascular coagulopathy - bleeding, bruising, liver and kidney dysfunction, confusion, shock.