Sepsis Flashcards
What is sepsis?
life threatening organ dysfunction caused by a dysregulated host response to infection
What is septic shock?
sepsis in combo with
- Either lactate >2mmol/L despite adequate fluid resus
- OR the patient is requiring vasopressor to maintain MAP>65mmHg
When do you give oxygen therapy?
reduced oxygen saturation or with an increase in oxygen requirement over baseline, to maintain oxygen saturation above 94% unless contraindicated
What is the sepsis 6?
- Give O2 to keep sats above 94%
- Take blood cultures
- Give IV antibiotics
- Give fluid challenge
- Measure lactate
- Measure urine output
What would you do FBC in sepsis?
- white cell count may be high or low
2. thrombocytopenia may indicate disseminated intravascular coagulation (DIC)
Why do you do clotting screen?
if abnormal may indicate coagulopathy/DIC.
What bloods are done?
- Serial ABGs, or VBGs for lactate
- Blood cultures
- U+Es
- CRP
- FBC
- LFT
- Clotting screen
What microsamples are done?
- Sputum and urine for MC&S
- Swab any wounds
- Consider LP
- Send fluid from lines or drains
- Joint aspiration
- Ascitic tap
What imaging is done in sepsis?
- CXR
2. Consider CT, USS,MRI, echo of suspected source
What antibiotics are given?
- Broad spectrum and should be given in 1h
- non-bacterial cover e.g. acyclovir if HSV encephalitis is suspected
What fluid do you give?
- Give within 1h if high risk SBP<90mmHg, AKI or lactate>2
- Give 500mL boluses of crystalloids with 130-154mmol/L sodium (e.g. 0.9% saline) over 15 mins – CAUTION WITHH HF
- If no improvement after 2 boluses consult with senior
What fluid bolus is given?
500mL boluses of crystalloids with 130-154mmol/L sodium (e.g. 0.9% saline) over 15 mins
What do you have to be careful with fluid bolus?
heart failure
What oxygen do you give for sepsis?
for target sats of 94-98% or 88-92% if patient at risk of CO2 retention e.g. severe COPD
