Sepsis Flashcards
1
Q
Sepsis PEARLS
A
- Document if cultures were obtained, date/time, and results if available
- Document date/time of the most recent lactate results if available
- If patient has antibiotics ordered or hanging, set rate in order to complete infusion within one hour
2
Q
When to tx Sepsis
A
Suspected infection w/ 2 or more SIRS criteria, & a minimum of 1 indicator of acute organ dysfunction
3
Q
Sepsis pt has not received IV ABX
A
Give Ceftriaxone 2 grams SIVP *Mix 2 grams in 20 mL NS)
4
Q
Sepsis tx for SBP <90 mmHg or MAP <65 mmHg
A
- 30mL/kg (IBW) LR IV bolus wide open, if MAP <65 mmHg, give additional 500-1000 mL LR fluid bolus concurrently while beginning Norepinephrine infusion
- Initiate Norepinephrine infusion
5
Q
Respiratory failure in septic shock requiring RSI w/ SBP <90 mmHg
A
Consider PDP Epi
6
Q
Pt has a central line
A
- Transduce & monitor CVP
- Initiate NS fluid boluses to target of 8-10 mmHg (not-intubated) / 10-12 mmHg (intubated)
7
Q
Unable to achieve SBP >90 mmHg w/ Norepinephrine @ 1 mcg/kg/min (IBW)
A
- Initiate Epi infusion @ 0-0.5 mcg/kg/min (IBW) Titrate to SBP >90 mmHg & MAP >65 mmHg
OR - Consult med control for Vasopressin @ fixed rate of 0.03 u/min (4.5 mL/hr) *Mix 40 u in 100 mL NS
8
Q
Peds Sepsis tx initiation
A
- Infant <1 yr SBP <50 mmHg
- Child 1-5 yr SBP <60 mmHg
- Child >5 yr SBP <70 mmHg
9
Q
When to tx Peds Sepsis
A
- Have ≥ 2 SIRS criteria & suspected or proven infection
- Hypotensive
OR a child w/ all 3: - Cold extremities
- prolonged capillary refill >3 sec
- Weak/fast pulse
10
Q
Peds sepsis (has not received Abx)
A
Ceftriaxone 50 mg/kg (up to 2 grams) SIVP
11
Q
Peds Sepsis tx
A
- Give 10-20 mL/kg bolus over 10-20 min. May repeat x2 (Monitor for s/s of fluid overload or myocardial dysfunction)
- If shock persists after 3 boluses, initiate Epi drip 0.1-1 mcg/kg/min
- Correct hypoglycemia as needed
- Consult w/ receiving md to correct hypocalcemia
