Sepsis Flashcards
What is SIRS?
Systemic inflammatory response syndrome
- Temp >38 or <36
- HR>90
- RR>20 or PaCO2<32
- WBCs>12,000 or <4000
What is sepsis?
Large immune response to an infection that causes systemic inflammation and affects the functioning of the body organs
What is severe sepsis?
Sepsis and organ dysfunction
What is septic shock?
Arterial BP drops and results in organ hypoperfusion
This leads to a rise in blood lactate as the organs begin anaerobic respiration
How is septic shock treated?
Treat aggressively with IV fluids to improve BP and tissue perfusion
What is the pathophysiology of sepsis?
Cytokine release
Increased vascular permeability causing oedema
Activation of coagulation system causing disseminated intravascular coagulopathy (DIC)
Blood lactate rises due to hypoperfusion causing anaerobic respiration
What are risk factors for sepsis?
Very young or old patients
Chronic conditions- COPD, DM
Chemotherapy, immunosuppressants, steroids
Surgery, recent trauma, burns
Pregnancy
Catheters, central lines
What are the signs of sepsis?
Fever >38
Hypothermia <36
Tachycardia >90
Tachypnoea >20
Altered mental status
Hyperglycaemia
What is usually the first sign of sepsis?
Tachypnoea
What is qSOFA?
Identifies patients with suspected infection who are likely to have a prolonged ICU stay or die in hospital
- Hypotension
- Altered mental status
- Tachypnoea
What investigations are done for sepsis?
FBC- assess WCC
U&Es- assess kidney function
LFTs- assess liver function
CRP- assess inflammation
Clotting- assess for DIC
Blood cultures- assess for bacteriaemia
Blood gas- assess lactate, pH and glucose
What is the management of sepsis?
The sepsis six
What is the sepsis six?
Three tests:
- Blood lactate level
- Blood cultures
- Urine output
Three treatments:
- Oxygen (maintain sats 94-98%)
- Broad spectrum antibiotics
- IV fluids (30ml/kg fluid challenge)
