SEPSIS Flashcards
What is Sepsis?
Life-threatening organ dysfunction caused by dysregulated host response to infection
What is Bacteremia?
Bacteria in the bloodstream
T/F: Bacteremia can be transient or overwhelming?
True.
Is a UTI a transient or overwhelming bacteremia?
Transient
Signs of Overhwhelming Bacteremia
(+) BCx, Sx
Fever, chills
SEPSIS SxS
Shivering/Fever Extreme Pain Pale skin Sleepy/confused "I feel like I might die" SOB
Sepsis v Septic Shock.
Septic shock can progress quickly Inability of body to compensate. - Lactic acid >2 -HYPOTENSION (MAP <65)
Severe Sepsis definition
Infection + SIRS+Organ dysfunction
“SIRS” in the setting of infection, assoc w/acute organ dysfunction
How do we quantify organ dysfunction?
Acute change in SOFA score
Septic Shock Definition. Key finding?
Subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound
HYPOTENSION
What is the Sofa Score?
What does a high score mean?
Sequential Organ Failure Assessment
High SOFA score means worse sepsis
Baseline SOFA score?
Baseline Sofa score is 0
How high does mortality risk increase with a SOFA score >2?
10% mortality risk in admitted pts
What lab value is not found in a sofa score?
lactic acid
is qSOFA sensitive enough to meet Sepsis Dx?
No
What are the disruptions to homeostasis in Severe Sepsis?
Inflammation activated
Coagulation Activated
Fibrinolysis Suppressed
What is the driving force in acute organ dysfunction and death?
Coagulopahty
What (Bacterial) cause of inflammation is activated in sepsis?
Lipopolysaccharide wall from gram (-) bacteria
What factors/mediators are released in response to sepsis?
Proinflammatory mediators, TNF, Interleukins, platelet activating factors
4 classic signs of Inflammation
Rubor-redness
Calor-Heat
Tumor- swelling
Dolor- Pain
Which mediators are responsible for cytokine storm?
Excess TNF, IL1 IL6
cause tissue & diffuse capillary injury
What are the 3 ways coagulation is activated in Sepsis?
- Inflammatory mediators released to fight infect also activate coagulation
- Infectious agent itself can cause endothelial damage=promotes coagulation
- Factors activated upon blood contacting damaged tissue= more clotting
T/F: D-dimer is a screening tool for Sepsis
False