Sepsis Flashcards
What may be coexistent in non-diabetics with SIRS?
Raised BM
5 criteria for SIRS? How many do you need?
Temp > 38.3 or < 36 HR > 90 RR > 20 or PaCO2 < 32mmHg WCC >12000 or <4000 Altered mental state
What are the common signs that someone is developing sepsis?
Bounding pulse
Warm peripheries
Any of the SIRS signs
Temp criteria for SIRS?
> 38.3 or < 36
HR criteria for SIRS?
> 90
Respiratory criteria for SIRS?
RR > 20 or PaCO2 < 32mmHg
White cell criteria for SIRS?
WCC > 12000 cells/mm3 or < 4000
When does sepsis become severe sepsis?
When there is detectable end organ damage
What are the signs that someone is severely septic?
Hypotension Decreased UO ( 2mmol/L Clotting dysfunction DIC, mottled skin CRT > 3 Reduced consciousness or altered mental state
What are the 2 criteria for septic shock?
Sepsis + either:
- persistent hypotension despite adequate fluid resus
- tissue hyperperfusion as demonstrated by lactate > 4mg/dL
What is the difference between warm and cold shock?
Warm = early. Peripheral dilation and increased cardiac output Cold = late. Relative hypovolaemia and reduced cardiac output leading to peripheral underperfusion
What is septic shock an example of?
Distributive shock
Define adequate fluid resus?
30ml/kg colloid
40-60ml/kg crystalloid
4 aims of primary resus for sepsis?
SaO2 > 95%
Systolic BP > 90, MAP > 75
Urine output > 0.5ml/kg/hr
Treat source of infection
What is the sepsis six?
High flow O2 via non re-breathe mask Blood cultures IV Abs IVT Measure lactate levels Monitor hourly UO (catheter)
How should O2 be administered in sepsis care?
High flow, via non-rebreathe mask
When should the sepsis six package have been carried out?
Within 1 hour
What things can be measured to identify end organ damage as a result of severe sepsis?
Creatinine Bilirubin Platelet count Urine output Lactate BP
What is an endocrine complication of septic shock?
Bilateral adrenal haemorrhage
What is Waterhouse-Friderichsen syndrome WFS also known as?
Haemorrhagic adrenalitis or fulminant meningococcaemia
What is the most common cause of WFS?
Meningococcal sepsis
What infectious agent has been implicated in WFS in kids?
Staph aureus
