SEPSIS

Question 1

What does TIME stand for?

Answer 1

T - Temperature, higher or lower than normal
I - Infection, may have s/s of infection
M - Mental Decline, confused, sleepy, difficult to arouse
E - Extremely Ill, severe pain, discomfort, shortness of breath

Question 2

What is Sepsis?

Answer 2

The body’s overwhelming immune response to severe infection and can result in damaging its own tissues and organs causing multi - organ failure and death. (SIRS +Infection)

Question 3

Name the 4 SIRS

Answer 3

1. Temperature > 38 degrees Celsius or < 36 degrees Celsius
2. Pulse - > 90 beats/minute
3. Respirations - > 20 breaths/minute or PaCO2 < 32
4. WBC’s > 12,000 or < 4,000 or > 10% bands

Question 4

What is Severe Sepsis?

Answer 4

Sepsis (SIRS + Infection) + End Organ Damage

Question 5

What is Septic Shock?

Answer 5

Severe Sepsis (Sepsis {SIRS + Infection} + End Organ Damage) + Hypotension or Lactate > or = 4.0

Question 6

Who is at Risk for Developing Sepsis?

Answer 6

1. Very Young
2. Very Old
3. Immunocompromised
4. Chronic/End stage Disease (Cancer, Cirrhosis, COPD, CHF, Chronic Renal Failure)
5. Wounds or Recent Surgeries
6. Indwelling Medical Device
7. Increased Length of Stay
8. Acute/Critical Illness

Question 7

True or False
It is very important to Validate all vital signs prior to documenting the Severe Sepsis Screening.

Answer 7

True

Question 8

On the Severe Sepsis Screening in Meditech you notice that the Temperature is marked yes but you do not remember the patient being febrile during your shift. Should you change that to a NO or leave it as it populated automatically?

Answer 8

Do not change any of the SIRS in Tier one as they auto populate and should never be changed.

Question 9

How many SIRS do you need to to rule in for Sepsis?

Answer 9

2

Question 10

How many SIRS are there?

Answer 10

4

Question 11

What is a suspected infection?

Answer 11

Purulent or foul smelling urine, painful urination
Draining, red or painful or foul smelling wound, incision or bite,
Fever with or without shaking and chills
Antibiotic use
Acute Abdomen pain, s/s of peritonitis
Abscess
Elevated WBC/decreased WBC
Difficulty breathing with cough and purulent sputum

Question 12

What is a confirmed infection?

Answer 12

WBC’s present in normally sterile body fluid
Pneumonia as per x ray or Dr note
Positive blood, urine or wound cultures
Abdominal CT (perforated viscus or Abdominal abscess)
Purpura

Question 13

How many Tiers are in the Severe Sepsis Screening?

Answer 13

3

Question 14

What does the different Tiers consist of in the Severe Sepsis Screening?

Answer 14

Tier One = SIRSs
Tier Two = Suspected or Documented Infection, Antibiotic Therapy, and Screening due to SPOT alert
Tier Three = Organ Dysfunction

Question 15

How many different organs do you assess for organ damage in the Severe Sepsis Screening?

Answer 15

7