sepsis Flashcards
what is sepsis
severe infection where the body’s response to infection injures it’s own tissues and organs
deregulated inflammation following infection
what is severe sepsis
life threatening sepsis
vital organ failure and are ill enough to go to ICU
what is severe sepsis characterised by
inflammation vasodilation leukocytaemia microvascular permeability organ/system failure
how can you recognise severe sepsis
arterial hypotension
blood lactate >2
impaired gas exchange
diminished responsiveness or confusion
how is septic shock defined
arterial hypotension for at least one hour despite fluids
serum lactate >4mmol/L after fluids
a type of distributive shock where abnormal blood flow results in inadequate tissue supply
what is SIRS
temperature 38
HR >110
resp rate >25
WBCs >11 or >4 x10 -3
affects organs and leads to multiple organ failure
also used for burns, trauma, pancreatitis and other non infectious illnesses
what organ systems should be monitored
CV resp neuro renal coagulation hepatic
what is MODS
multiple organ dysfunction syndrome
what are toll like receptors
surface receptors in the innate immune system
what effect do TLRs have
increased blood flow cortisol, oestrogen and adrenaline platelet activation increased metabolism increased mitochondrial activity
what can explain organ function recovery after sepsis
mt adopt low energy state
what are the risk factors for sepsis
malignancy Age > 65 immunocompromised dialysis alcoholism diabetes chronic kidney disease
what is the sepsis 6
monitor urine antibiotics fluid resus oxygen blood lactate cultures
what are the 3 levels of wards
ward
high dependency unit
intensive therapy unit
what are the principles of treatment
early recognition early stratification specific goals in mind early antibiotics triage of care sbar handover
