Sepsis

Question 1

What is sepsis?

Answer 1

Sepsis is the body’s extreme immune response to a local infection in the body which has then spread and triggers the immune response.

Question 2

Infections that lead to sepsis most often start in the…

Answer 2

Lungs, skin, urinary tract, skin or GI tract.

Question 3

Explain the pathophysiology of sepsis

Answer 3

-Local infection has spread to the rest of the body which triggers the immune system to go into over-drive
-Infective material such as bacteria, virus etc. attract white blood cells
-White blood cells release chemicals which cause systemic vascular dilation of blood vessels + increased permeability
-This causes reduced blood flow and so it becomes difficult to provide oxygen to cells. Cells respire anaerobically and so this leads to raised lactate.
-

Question 4

What are the clinical features of sepsis?

Answer 4

Temperature outside 36-38
HR>90bpm
RR>20
BP systolic <90mmHg
Decreased oxygen saturations
Reduced urine ouput

Question 5

How would you manage a septic patient? Give 3 + Take 3

Answer 5

ABCDE

Give 3:
1. Oxygen to maintain target saturations
2. IV fluids
3. IV broad-spectrum antibiotics

Take 3:
1. Blood cultures + bloods
2. VBG - lactate + pH
3. Measure urine output