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Yr 3 - RRAPID > Sepsis > Flashcards

Sepsis Flashcards

1
Q

What is sepsis?

A

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

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2
Q

Give some patient groups who are more at risk of sepsis

A
  • Children <1
  • Adults >75
  • Frail
  • Immunocompromised
  • Post-surgery
  • Damage to skin e.g. burns, blisters, wounds
  • IV drug users
  • Lines or catheters
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3
Q

Give some symptoms of sepsis

A
  • Localising symptoms of infection e.g. productive cough, vomiting, diarrhoea, dysuria
  • Confusion
  • Drowsiness
  • Clammy/sweaty
  • Malaise
  • SOB
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4
Q

Give some signs of sepsis

A
  • Tachycardia
  • Tachypnoea
  • Hypotension
  • Fever or hypothermia
  • Cyanosis
  • Low O2 sats
  • Delayed CRT
  • Oliguria
  • Dry mucous membranes
  • Non-blanching rash
  • Mottled/ashen appearance
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5
Q

How is the CRT affected by sepsis?

A

Prolonged

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6
Q

How is urine output affected by sepsis?

A

Oliguria

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7
Q

Define oliguria

A

Reduced urine output (oliguria) is typically defined as <0.5ml/kg/hour in an adult

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8
Q

What RED FLAGS can be seen in sepsis in ‘breathing’

A
  • Tachypnoea → RR >/= 25
  • Low O2 sats → oxygen required to keep SpO2 >/= 92%
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9
Q

What RED FLAGS can be seen in sepsis in ‘circulation’?

A
  • Hypotension → systolic BP = 90 mmHg
  • Tachycardia → HR >130 bpm
  • Prolonged CRT
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10
Q

What lactate level is a red flag for sepsis?

A

Lactate >/= 2 mmol/l

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11
Q

What RED FLAGS can be seen in sepsis in ‘disability’?

A
  • Responds only to voice or pain, or unresponsive (ACVPU)
  • Acute confusional state
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12
Q

What RED FLAGS can be seen in sepsis in ‘exposure’?

A
  • Non-blanching rash
  • Mottled, ashen appearance or cyanotic
  • Urine output <0.5 ml/kg/hour
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13
Q

What urine output is a red flag for sepsis?

A

Urine output <0.5 ml/kg/hour

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14
Q

If sepsis is suspected, what are your management steps?

A

Blood cultures

Urine output

Fluids IV

Antibiotics IV

Lactate

Oxygen

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15
Q

What should always be checked before administering antibiotics?

A

allergies → red penicillin band?

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16
Q

What RR is a red flag for sepsis?

A

>/= 25 (tachypnoea in general suggests sepsis)

17
Q

What SpO2 suggest sepsis?

A

Hypoxaemia (<94%)

18
Q

What symptoms may indicate the chest as the source of sepsis?

A

a productive cough with purulent sputum

19
Q

What auscultation findings may indicate the chest as the source of sepsis?

A

bronchial breath sounds and/or coarse crackles indicate consolidation (pneumonia → sepsis)

20
Q

What percussion findings may indicate the chest as the source of sepsis?

A

Dull

21
Q

What intervention should be done in ‘breathing’ in patients with suspected sepsis? Why?

A

Sit up & 15L/min oxygen via non-rebreathe mask

To try correct hypoxaemia

22
Q

What investigations should be ordered in ‘breathing’ in suspected sepsis?

A

ABG

Portable CXR

Sputum culture (if appropriate)

23
Q

How is BP affected in sepsis?

A

Hypotension

Systolic BP = 90 mmHg or a drop of >40 mmHg from the patient’s normal blood pressure is considered red flags for sepsis

24
Q

How is pulse affected in sepsis?

A
  • Tachycardia is a common feature of sepsis
  • HR >130 bpm is a red flag for sepsis
25
Q

How is CRT affected in sepsis?

A

Prolonged

26
Q

Why is it important to assess the patient’s fluid levels?

A

to inform resuscitation efforts

27
Q

How can the patient’s fluid levels be assessed?

A

oral fluids, IV fluids, urine output, drain output, stool output, vomiting

28
Q

What causes oliguria in sepsis?

A

patients with sepsis are typically intravascularly depleted due to third space fluid loss

29
Q

What is 3rd space loss?

A

this refers to losses into spaces that aren’t visible e.g. bowel lumen, retroperitoneum

30
Q

What is your response to a hypotensive patient?

A

Insert 2x wide bore cannulae (one in each antecubital fossa)

Give 500ml 0.9% saline over 15 minutes

31
Q

What blood tests

A

Yr 3 - RRAPID (4 decks)

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