Sepsis

Question 1

WHat is SIRS?

Answer 1

Systemic Inflammatory Response Process

Question 2

What is Sepsis?

Answer 2

SIRS + Infection

Question 3

What qualifies SEVERE Sepsis?

Answer 3

Evidence of organ dysfunction

Question 4

What is Septic Shock?

Answer 4

Sepsis and Hypotension despite adequate fluid resuccitation

Question 5

WHat are the Source Specific clinical Symptoms of Sepsis?
Skin
Resp
GI 
GU
Blood Borne

Answer 5

Skin: Erythema, swelling, drainage
Resp: cough, sputum, chest pain
GI: abd discomfort, pain, distention, diarrhea, N/V, jaundice
GU: dysuria, hematuria, flank pain, 
BB: Non-specific

Question 6

Who is at risk for sepsis?

Answer 6

DM
Malnutrition
Malignancy
Immunosupression
Chronic Steroids
Immune def
Post Transplant

Question 7

Why is the source/location of the infection important?

Answer 7

Can tell you what kind of bacteria, what Abtx you need to use

Question 8

What labs do you order with suspected Sepsis?

Answer 8

CBC: Leukocytosis or penia
Thrombocytosis or penia
Anemia
Creatine, K+
Bicarb
Lactate
Glycemia
LFT
Coag Profile, PT, PTT, INR
ABG (pH)

Question 9

What makes up SIRS Criteria?

***

Answer 9

Temp >38C(100.4) or 90

RR >20 or PaCO2 12k, 10% bands

Question 10

What is the APACHE II score used for?

Answer 10

Determine risk of mortality in the ICU

Question 11

WHat are the first steps in a Pt with possible sepsis?

Answer 11

IV Site
BP Monitoring
Urinary Cath

Question 12

What is the equation used to calc. MAP?

Answer 12

MAP = (SABP + 2 DABP)/3

Question 13

What is the treatment of choice for fluid therapy?

Answer 13

Crystalloids (Lactated ringers?)
30mL/kg 2 L
1x 16 guage
2x 18 guage

Question 14

What vasopressors are used in Septic Shock?

Answer 14

NE
EPI
Vasopressin

Question 15

What are the guidelines for Antibiotic therapy?

Answer 15

The sooner the better!
Broad spectrum Empiric Abtx within one hour of Hypotension
De-Escalate to more specific therapy ASAP
Monitor Lactate to know if your therapy is working