Sepsis Flashcards
what is sepsis according to sepsi 3 recomendations
life threatening organ dysfunction cused by dysregulated host response to infection
sofa score
sequentail organ failure assessment score
change in sofa score significance
acute change in SOFA score of 2 or more suggest organ dysfunction and mortality of 10%
not a management tool
SOFA score components -
respiratory PaO2 FiO2 ratio renal - creatinine hepatic - bilirubin cardiovascular MAP platelet count GCS
qSOFA
hypotension SBP <100
altered mental status
RR >22
score of 2 or more suggests greater risk poor outcome
sepsis organisational factors
sepis lead ITU with outreach sepsis protocol validated EWS obs in ED abx in 1 hour reviewed by consultant 14 hours
EWS parameters
airway RR SBP HR AVPU temp UO for 2 hours
NEWS score
RR Sats any oxygen temp SBP HR AVPU
risk criteria of NEWS
0-4 ward based response any parameter over 3 urgent ward based response aggregrate score 5-6 key threshold urgent response 7 or more emergency response
sepsis 6
oxygen blood cultures iv abx fluid lactate and hb hourly urine output measurement
lactate level and mortality
lactate less than 2 15%
2-4 25%
> 4 38%
fluid resuscitation
if SBP less than 90 or lacate more than 2
fluid bolus 500mls over 15 mins
repeat no improvement
fluid resuscitation
if SBP less than 90 or lacate more than 2
fluid bolus 500mls over 15 mins
repeat no improvement
Sepsis spiel
patients should be resuscitated systematically in a airway to exposure manner adhering to the principles of the sepsis 6 protocol
