Sepsis

Question 1

Sepsis is a ___________________________________________ caused by a _____________________ to infection.1

Answer 1

life-threatening organ dysfunction

dysregulated host response

Question 2

• Infection = Sepsis

T/F

Answer 2

F

• Infection ≠ Sepsis!!!

Question 3

Sepsis is a global challenge

T/F

Answer 3

T

Question 4

Sepsis has more than just short term consequences.
–_______ of patients are re-admitted within ____ days, while _____ die within 1 year.2
–______ have severe, persistent impairment:
i. Recurrent infections
ii. Functional, cognitive and behavioral problems (anxiety, depression, & PTSD)
iii. CKD
iv. New cardiovascular events
v. Impaired immunity

Answer 4

2/5; 90

1/3 ; 1/6

Question 5

Sepsis 2.0 Definitions3

SIRS:_____,_______,________,_______

Sepsis = _____ + ______

Sepsis Shock=_______ associated with ____________, systemic __________ or _________

Answer 5

> 38, <36
Heart rate >90/min
Respiration >20/min
<4000 or >11000

SIRS; infection

sepsis; organ dysfunction; hypoperfusion or hypotension

Question 6

Sepsis 3.0 Definition

Topic; traditional def; sepsis 3 def

Sepsis; suspicious infection+>2 SIRS ; _______________________

Severe sepsis : ______________; __________

Sepsis shock: sepsis + _____________ even after ___________ ; sepsis + ______________

Answer 6

suspicious infection+>2 SOFA

Sepsis + organ failure ; not a category

Refractory hypotension after adequate fluid ; vasopressors and lactate

Question 7

Septic shock

A subset of sepsis in which underlying __________,_________,__________ abnormalities are associated with a greater risk of mortality than sepsis alone.

Answer 7

circulatory, cellular, and metabolic

Question 8

Criteria for identification of septic shock :

– Sepsis (with SBP < _____mmHg) + need for _______ therapy to maintain MAP >_____mmHg.

– Serum lactate >____ mmol/L despite ___________________________________.

Answer 8

90; vasopressor; 65

2

adequate fluid resuscitation

Question 9

SOFA = _______________________

Answer 9

Sepsis -related organ failure assessment

Question 10

Sepsis clinical criteria

________ + _________

Answer 10

Sepsis

SOFA

Question 11

Criteria in SOFA!

Answer 11

Decreased Glasgow coma scale
Decreased PaO2/FiO2
Increased bilirubin
Decreased platelets
Increased creatinine , oliguria
Hypotension of vasopressors

Question 12

Criteria in qSOFA

Answer 12

Respiratory rate >22 cpm
Altered cognition
SBP <100mmHg

Question 13

Various criteria for early recognition of Sepsis
• SIRS (_________________________________)
• SOFA (_________________________________)
• qSOFA (_________________)

Answer 13

systemic inflammatory response syndrome

sequential organ failure assessment

quick SOFA

Question 14

Various criteria for recognition of early sepsis

• NEWS (____________________)
• PRESEP (______________________)
• SPEED (————————————- )
• PIRO (_________________________________)

Answer 14

national early warning system

pre-hospital early sepsis detection

sepsis patient evaluation in the emergency department

predisposition, infection/insult, response and organ dysfunction

Question 15

APPROACH TO MGT of sepsis and septic shock
A. EARLY RECOGNITION

B. INITIAL RESUSCITATION (BUNDLING CARE –________)
1) Measure ____________; repeat if > 2mmol/L
2) Obtain _____________
3) Administer ___________________
4) Begin rapid administration of IVFs if ____________ or ________ ≥ 4 mmol/L
5) Apply __________ if patient is hypotensive during or after fluid resuscitation to maintain MAP 65mm Hg
B. SOURCE CONTROL (____-_____ hours)
C. PREVENTING SHORT TERM AND LONG TERM
COMPLICATIONS

Answer 15

1 hour; serum lactate

blood cultures

broad spectrum antibiotics

IVFs ; hypotensive or serum lactate

vasopressors

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