Sepsis Flashcards
1
Q
SIRS Criteria (need 2 or more)
A
- Temperature > 38 C or < 36 C
- HR > 90 bpm
- RR > 20 bpm or PaCO2 < 32 mmHg
- WBC count > 12,000/cu mm, < 4000/cu mm, or >10% band forms
2
Q
Define sepsis
A
The presence of SIRS along with clinical or microbiologic evidence of an infection
3
Q
Define septic shock
A
Sepsis induced hypotension despite adequate fluid resuscitation, along with perfusion abnormalities (lactic acidosis, oliguria, acutely altered LOC)
4
Q
Sepsis is…
A
- Common
- Increasing in incidence
- Deadly
5
Q
Outline the patho of sepsis
A
- Infection
- Inflammatory mediators (3 amigos)
- Vasodilation and endothelial damage
- Hypotension, microvascular plugging, vasoconstriction, edema
- Inappropriate distribution of microvascular blood flow
- Ischemia
- Cell death
- Organ dysfunction
6
Q
Top 3 organisms isolated in septic shock (from class)
A
- E. coli
- S. aureus
- S. pneumoniae
7
Q
Clinical features of sepsis
A
- Fever
- Confusion
- Increased WBC count
- Tachypnea
- Tachycardia
- Hypotension
- Decreased vascular tone
- Organ dysfunction
8
Q
Clinical signs of septic shock
A
- Myocardial depression
- Altered vasculature
- Altered organ perfusion
- Imbalance of 02 delivery and consumption
- Lactic acidosis
9
Q
Management of sepsis
A
- Fluid resuscitation
- Cultures prior to giving antibiotics
- Early targeted antibiotics and source control
- Give vasopressors/inotropes
10
Q
What is the most common cause of sepsis, Gram +ve or Gram -ve organisms?
A
Gram +ve
11
Q
Sepsis management points
A
- Failure to implement source control = higher mortality
- Using an ineffective antibiotic = higher mortality
- Delaying antibiotic administration = higher mortality
- Hit it early and hit it hard
12
Q
Preventing complications of sepsis
A
- Prophylaxis for DVT to prevent a possible PE
- Stress ulcer prophylaxis (i.e. PPI)
- Elevate head to 45 degrees to prevent HAP
- Interrupt sedation daily to facilitate extubation
13
Q
Define SIRS
A
The systemic inflammatory response to a variety of severe clinical insults
