Sepsis

Question 1

Septic Shock

Answer 1

• Requires vasopressor to keep MAP 65+
• Serum lactate >2
• MODS

Question 2

Sepsis Early S&S

Answer 2

• CO low
• BP low

Question 3

Sepsis S&S (worsening)

Answer 3

• CO high
• HR & BP high
• CVP normal
• Warm skin
• DIC = widespread hypoxia
• Hemorrhage
• Severe hypovolemic shock S&S
• ARDS from SIRS
• Pallor
• Mottling
• Cyanotic
• Petechiae
• Ecchymoses
• Blood oozes from venipuncture sites, gums, mucous membranes
• Oliguria
• Impending doom

ARDS = high mortality rate!

Question 4

Sepsis Labs

Answer 4

• Lactate >2
• Procalcitonin high
• WBC high
• H/H levels change in late shock

Question 5

Hour-1 bundle for managing sepsis

Answer 5

• Measure lactate
• Cultures before Abx
• Broad-spectrum abx
• Crystalloids for HOTN or lactate >4
• Vasopressors