Sepsis Flashcards
Define colonisation.
The presence of a microbe in the human body that does not cause infection or a specific immune response
Define infection.
The occurrence of inflammation due to the presence of a microbe
Define bacteraemia.
The presence of a viable bacteria in the blood
Define sepsis.
SIRS plus a documented infection site
i.e. positive cultures from that site
What does SIRS stand for?
Systemic Inflammatory Response Syndrome
A patient is classed as having SIRS if they have 2 or more of certain criteria. List these potential criteria.
Temperature >/= 38C or 100bpm
Respiration > 20/min
Leukocyte count > 16000/mm3, 10% immature cells
Define severe sepsis.
Sepsis associated with organ dysfunction, hypo perfusion abnormalities or hypotension
Give some examples of hypo perfusion abnormalities.
Lactic acidosis
Oliguria
Acute alteration in mental status
Define septic shock.
Sepsis induced hypotension despite fluid resuscitation plus hypo perfusion abnormalities
Name some risk factors associated with sepsis.
Diabetes Asplenic patients Cancer Immunosuppression Sever wounds/burns Prosthetic devices Extremes of age
Name some common pathogens associated with the infection element of sepsis.
Staph. aureus Neisseria meningitidis Streptococcus Strep pneumoniae Gram negative bacilli Candida species
List the stages of pathophysiology.
Infection Host defence mechanism activation Neutrophil & monocyte influx Release of infalmmatory mediators EITHER vasodilation OR diffuse endothelial dysfunction leading to increased epithelial permeability OR activation of coagulation
List some symptoms and signs of sepsis.
Headache Neck stiffness Photophobia Pleural effusion Diarrhoea Abdominal pain/tenderness Neutropenic haematology Loin pain Dysuria Haematuria Swelling/Redness/Tenderness Cellulitis Petechial rash Wounds Altered consciousness/confusion Tachypnoea Hypoxaemia Reduced albumin Reduced platelets Increased D-dimer Reduced fibrinogen Tachycardia Hypotension Prolonged capillary refill Warm or cool peripheries Lactic acidosis Oliguria Anuria Hypo/Hyperglycaemia Hypocalcaemia Abnormal skin temperature
How does diagnosis of sepsis vary?
According to type of infection and SIRS present Blood tests Microbiology Viral studies Serological blood tests
List the SEPSIS SIX.
Administer high flow OXYGEN Take BLOOD cultures Give BROAD SPECTRUM ANTIBIOTICS Give IV fluid challenges Measure SERUM LACTATE & HAEMOGLOBIN Measure accurate hourly URINE OUTPUT (Potentially request imaging)
