SEPSIS Flashcards
Sepsis is a
life-threatening ORGAN DYSFUNCTION caused by dysregulated host response to infection
Septic Shock is
a subset of sepsis with circulatory and cellular/metabolic dysfunction assoc. with higher risk of mortality
shock distributes with LOSS of peripheral vascular tone, persistent hypotension
FINAL STAGES INCLUDE END ORGAN FAILURE.
SIRS- Systemic Inflamm Response Syndrome
abnormal host response characterized by generalized inflammation in organs remote from patients initial injury
(infectious or non infectious)
SIRS criteria
2 or more of the following:
- body temp >38 C
- HR >90 bpm
- resp rate >20 rpm
- WBC elevated
is SIRS infectious?
IT CAN BE or CANNOT be
sepsis is what 2 things combined
SIRS and an Infection
(the source of the SIRS is infection)
Sepsis- what initial steps do you take
- measure lactate level (byproduct of anaerobic resp=difficult getting O2 in)
- cultures prior to antibiotics
- Empiric IV Abx
- Fluid resuscitation
- vasopressor for persistent hypotension
Sepsis- diagnosis
blood cultures before antibiotics
Septic Shock is
sepsis with PERSISTENT hypotension requiring vasopressors, despite the adequate fluid resuscitation
lactate > 2mmol/L
Septic Shock- initial resuscitation (what do you give)
at least 30 ml/kg IV crystalloid or saline fluid within first 3 HOURS
- bolus
Septic shock Antimicrobial Selection should include
BROAD SPEC: cefepime, piperacillin-tazobactam, and carbapenem
MRSA: IV vancomycin
Septic Shock Source Control
remove line or catheter if contributing to the sepsis
- foley catheter and UTI can cause sepsis, must remove catheter as source control
Lactate guides fluid resuscitation in these 3 cases:
- global tissue hypoxia
- anaerobic respiration
- trending lactate levels
Septic shock and vasopressors
- give vasopressors if pt is not responding to fluids
- aim for MAP of 65 mm Hg
Septic Shock first-line agent vasopressor
Norepinephrine is FIRST LINE vasopressor
