Sepsis Flashcards
clinical presentation of SIRS
tachycardia fever tachypnea leukocytosis leukopenia
clinical presentations of severe sepsis
sepsis
organ system dysfunction (acidosis, encephalopathy, oliguria, hypoxemia, coagulopathy)
clinical presentation of septic shock
hypotension
as sepsis progresses morbidity increases, t or f
true
widespread systemic inflammatory response as a result of
SIRS
SIRS is most likely triggered by
infection - can be a variety of things
SIRS Dx Criteria
temp >38 C or 100.4 F
HR >90
RESP >20
WBC >12,000 or
How many dx criteria must be met to suspect SIRS
2 or more
what is sepsis
infection + SIRS
what is SIRS
systemic inflammatory response syndrome
mgmt. of sepsis
baseline lactate levels blood cultures (before broad spectrum antibiotics) fluid resuscitation broad spectrum antibiotics (first) GOAL *within 3 hours of presentation
dx of sepsis
infection is known
temp >38 C or 100.4 F OR 90
RESP >20
WBC >12,000 or
sepsis can develop to severe sepsis quickly, t or f
true
what s/s are evident with severe sepsis
Hypotension Chills Decreased urine output Decreased skin perfusion Poor capillary refill Skin mottling Decreased platelets Petechiae Hyperglycemia Mental status changes
recommended timeframe for sepsis control (from dx to intervention)
within 12 hours
1st line vasopressor in sepsis
epinephrine
when are blood products recommended for sepsis
platelet’s less than 10,000-20,000
hemoglobin
2 meds used to prevent stress ulcers
proton pump inhibitor (protonix) H2 blocker (Pepcid)
should pt. eat in severe sepsis
yes - little amounts
enteral feedings if cant eat
surviving sepsis 3 hour window
measure lactate level
obtain blood cultures prior to admin of antibiotics
admin broad spectrum antibiotics
admin 30ml/kg crystalloid for hyptotension or lactate
what is septic shock
sepsis with hypotension despite medical intervention and perfusion abnormalities
lactic acidosis
early s/s of septic shock
tachy w/bounding pulse BP norm/low widened pulse pressure warm, flushed skin irritable, confused oliguria hyperthermia increased CO SvO2 decreased RAP and SVR
late s/s of septic shock
tachy w/weak, thready pulse hypotension narrow pulse pressure cool, clammy skin lethargy/coma anuric hypothermia decreased CO and SvO2
mgmt of septic shock
trt cause (identify within 1 hr) max. o2 delivery and decrease demand max cardiac output (keep cvp >8 and HR
