sepsis Flashcards
what is maternal sepsis ?
life threatning condition defined as organ dysfunction due to infection during pregnancy, child birth, post abortion or the post partum period
what are the components of sepsis ?
infection along with systemic manifestations of sepsis
what are the components of severe sepsis ?
sepsis
sepsis induced organ dysfunction
or tissue hypo-perfusion
what is septic shock ?
the persistence of hypo-perfusion despite adequate fluid replacement therapy
what may organn failure in severe sepsis present as ?
acute respiratory distress
hypotension
acute renal injury
what are the clinical features suggestive of sepsis ?
fever hypothermia persistent tachycardia tachypnea diarrhea or vomiting rash abdominal tenderness off vaginal discharge urinary symptoms abnormal or absent fetal heart beats
what investigations can be carried out ?
blood test ( CBC, UREA, lactate, creatinine, ALT AST )
blood culture
chest x ray
blood culture should be sent before Ab therapy
what does the resuscitation bundle associated with sepsis include ?
blood culture prior to antibiotics
empirical antibiotics
serum lactate in 6 hours
vasopressor therapy
what is the problem with using co-amoxicalv in maternal sepsis ?
risk of necrotizing enterocolitis in neonates
what is the problem with using metronidazole only ?
only covers anaerobes
what cann be used for vasopressor therapy ?
noradrenaline
what is the goal mean arterial pressure ?
more than 65 mmhg
what are the indications for admission to the ICU ?
hypotension or raised serum lactate despite fluid resuscitation pulmonary oedema need for mechanical ventilation airway protection renal dialysis decreased consciousness level multi-organ failure uncorrected acidosis hypothermia
if fetal delivery is indicated what are the different conditions for each gestational period ?
if it is preterm :
steroids for fetal lung maturity
intrapartum:
continuous electronic fetal monitoring
what type of anesthesia should be used for CS in septic women ?
general anesthesia should be used
spinal should be avoided
