Sepsis

Question 1

Pathophysiology of sepsis

Answer 1

• Life threatening organ dysfunction due to dysregulated host immune response to infection
• Micro-organisms enter bloodstream –> systemic changes
• Cytokines cause widespread vasodilation

Question 2

Red flags of sepsis

Answer 2

• Responds only to voice/pain/unresponsive
• Acute confusional state
• Systolic <90 or drop >40 in systolic
• HR >130
• RR >25
• Needs O2 to keep sats above 92%
• Non-blanching rash, mottled skin, cyanosis
• Not passed urine in last 18hrs or <0.5ml/kg/hr
• Lactate >2
• Recent chemotherapy

Question 3

Sepsis 6

Answer 3

GIVE:
* O2
* Fluids
* IV abx
TAKE:
* Blood cultures
* Hb and lactate
* Urine output

Question 4

Which fluids in sepsis?

Answer 4

500ml bolus of 0.9% saline or Hartmann’s (straight away or over 15 mins)
Do this until 2L - if BP still low, think about other measures, involve senior