Sepsis

Question 1

What are the SIRS criteria?

Answer 1

2 of the following:

• Temperature >38C or <36C
• Respiratory Rate >20/min
• Pulse >90bpm
• WBC >12 or <4 x 10^9/L

Question 2

What is SOFA?

Answer 2

This is the sequential organ failure assessment score, scored from 0-4

Question 3

How is organ dysfunction quantified in SOFA?

Answer 3

Acute change in total SOFA score of 2 or more

Question 4

What is qSOFA? Remember HAT

Answer 4

This is like SOFA but is a quick bedside assessment.
The patient has sepsis if they have 2 or more of:
- Hypotension –> systolic <100mmHg
- Altered mental state –> GCS<15
- Tachypnoea –> RR>22/min

Sepsis = qSOFA + evidence of infection

Question 5

Which patients may not have a classical presentation of sepsis?

Answer 5

Elderly, immunosuppressed (no fever)

Question 6

What are the sepsis 6 for treatment of sepsis?

Answer 6

3 in, 3 out:
IN: Oxygen
IN: Fluids
IN: Antibiotics
OUT: Lactate
OUT: Blood cultures
OUT: Urine output

Question 7

Name some crystalloid fluid solutions

Answer 7

Useful for short term fluid replacement:

• Normal Saline (0.9%)
• Dextrose
• Hartmanns
• Ringers

Crystalloids contain minerals salts and other water soluble molecules

Question 8

Name some colloid fluid solutions

Answer 8

Give with care as they can cause anaphylaxis:

• Blood
• Albumin

Colloids contain larger insoluble molecules

Question 9

What is septic shock?

Answer 9

Sepsis with circulatory and cellular/metabolic abnormalities that can cause an increase in mortality

Question 10

What is sepsis?

Answer 10

Life-threatening organ dysfunction due to a dysregulated host response to an infection (NB must include organ dysfunction)

Question 11

What are the core presentations of sepsis?

Answer 11

Abdo pain, abnormal bowel habit, collapse, confusion, cough, dysuria, fever, headache, urinary incontinence, infection, shock