Sepsis Flashcards
Q: What is the importance of early recognition and treatment of sepsis?
A: Early recognition and treatment of sepsis significantly reduce mortality and improve patient outcomes by preventing deterioration and organ failure.
Q: What tool is used to identify patients at risk of sepsis in hospitals?
A: NEWS 2
Q: What are the high-risk (‘Red Flag’) criteria for sepsis?
A:
NEWS2 score ≥7 or NEWS2 5-6 with one of the following:
Any single NEWS2 parameter scoring 3.
Mottled or ashen skin.
Non-blanching rash.
Cyanosis of skin, lips, or tongue.
Serum lactate >2 mmol/L.
Acute kidney injury (AKI).
Q: What are the moderate-risk (‘Amber Flag’) criteria for sepsis?
A:
NEWS2 score of 5 or 6 without high-risk features.
Clinical signs like mottled skin, non-blanching rash, cyanosis, or deterioration.
Q: What are the vital signs and assessments for recognizing sepsis?
A:
Respiratory rate >25 breaths/min.
Heart rate >130 beats/min.
Blood pressure: Systolic ≤90 mmHg or drop >40 mmHg.
Temperature: High or low, but not always present.
Oxygen saturation: Low SpO₂ levels.
Mental state: New confusion or reduced consciousness.
Urine output: Reduced or absent.
Q: Why is respiratory rate an important sign in sepsis?
A: Increased respiratory rate is an early sign of critical illness due to tissue hypoxia and lactic acidosis, which can indicate sepsis.
Q: How does sepsis affect heart rate and blood pressure?
A:
Sepsis causes vasodilation and capillary leakage, leading to hypovolemia.
This triggers the sympathetic nervous system to increase heart rate to maintain organ perfusion.
Blood pressure may drop due to reduced vascular resistance.
Q: How is oxygen saturation used in identifying sepsis?
A:
Sepsis causes hypoxia, so peripheral oxygen saturation should be monitored.
In cases of poor circulation, an arterial blood gas sample may be necessary.
Q: What is the significance of reduced urine output in sepsis?
A:
Oliguria (<0.5 mL/kg/hr) indicates poor kidney perfusion and risk of acute kidney injury (AKI).
Reduced urine output suggests compromised cardiac output and requires urgent action.
Q: What skin changes are associated with sepsis?
A:
Mottled or ashen skin.
Non-blanching purpuric rash.
Cyanosis of lips, tongue, or extremities.
Q: What mental state changes are signs of sepsis?
A:
New confusion or disorientation.
Reduced consciousness (assessed using the ACVPU scale).
Behavioral changes in patients with dementia or learning disabilities.
Q: What is neutropenic sepsis, and how is it managed?
A:
Neutropenic sepsis occurs when neutrophils drop below 0.5 x 10⁹/L after chemotherapy.
Requires urgent IV antibiotics within 1 hour of hospital arrival.
Q: Why is serum lactate measurement important in sepsis?
A:
Elevated serum lactate (≥2 mmol/L) indicates tissue hypoxia and metabolic distress.
A lactate level >4 mmol/L is linked to a 38% risk of death.
Q: How should patients with suspected sepsis be monitored?
A:
Perform continuous or 30-minute interval observations.
Use structured assessments like NEWS2 for patients over 16 years.
Follow local guidelines for pediatric and pregnant patients.
Q: What role does family or carers’ input play in recognizing sepsis?
A:
Family or carers can help identify subtle behavioral changes or deteriorations in patients with cognitive impairments, aiding early sepsis detection.
Q: What is the Sepsis Six bundle, and why is it important?
A:
The Sepsis Six is a set of urgent actions to be completed within 1 hour of identifying sepsis:
Administer oxygen to maintain SpO₂ >94%.
Take blood cultures.
Administer IV antibiotics.
Measure serum lactate and check for AKI.
Start IV fluids to correct hypotension.
Monitor urine output.
It improves survival rates by initiating early treatment.
Q: How does sepsis present differently in vulnerable groups?
A:
Older adults may show confusion or behavioral changes instead of fever.
Children can present with irritability, lethargy, or reduced feeding.
People with learning disabilities or cognitive impairment may have subtle changes in mood or function.
Use information from carers and consider health passports for tailored care.
Q: How is point-of-care lactate testing used in sepsis detection?
A:
Rapid bedside lactate testing allows early detection of tissue hypoxia.
It can be done via a fingertip blood sample in ambulances and emergency departments.
A lactate level of ≥2 mmol/L signals the need for urgent action.
Q: Why is a chest X-ray important in patients with suspected sepsis?
A:
A chest X-ray helps identify respiratory infections, such as pneumonia.
It supports diagnosis when the source of infection is unclear.
Recommended when sepsis is suspected with respiratory symptoms.
Q: What safety measures should be taken for patients with reduced consciousness due to sepsis?
A:
Use the ACVPU scale to assess consciousness.
Place the patient in the recovery position if unresponsive.
Raise bed rails if appropriate to prevent falls, following risk assessments.
Monitor closely for airway obstruction and aspiration risk.
Q: What is the Sepsis Six care bundle, and why is it important?
A:
A set of six key interventions to be completed within 1 hour of sepsis identification to improve survival.
Senior clinician review to confirm diagnosis and guide treatment.
Administer oxygen if required.
Obtain IV access and take bloods (including cultures, lactate).
Give IV antibiotics immediately.
Start IV fluids to correct hypovolemia.
Monitor NEWS2, urine output, and lactate.
Q: Why must a senior clinician assess the patient as part of the Sepsis Six?
A:
To differentiate sepsis from similar conditions (e.g., pancreatitis, dehydration).
To guide the most appropriate treatment and antibiotic selection.
Q: When and how should oxygen be administered in sepsis?
A:
15 L/min via a non-rebreathing mask for most patients.
Aim for oxygen saturation of 94–98% or 88–92% in chronic lung disease.
Oxygen must be prescribed as soon as possible.
Q: What blood tests are essential in sepsis management?
A:
Blood cultures before antibiotics (if possible).
Full blood count (FBC), urea and electrolytes (U&E), creatinine, C-reactive protein (CRP).
Lactate levels and blood gas analysis.
