Sepsis Flashcards
Bacteraemia
Presence of viable bacteria in the blood
Sepsis
Medical Emergency
The systemic inflammatory response to infection - SICKER.
Life threatening organ dysfunction caused by a dysregulated host response to infection
Septic Shock
subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality.
SIRS criteria***
- score needed
- criteria
(primary criteria)
SIRS criteria***//
“Systemic Inflammatory Response Syndrome”
- Temperature >38 or <36
- HR >90
- RR > 20
- White cell count >12000 or <4000
Sepsis is present when 2 or more of these are present.
SIRS can also be caused by trauma, pancreatitis & burns
qSOFA
not used as often
quick SEPSIS RELATED ORGAN FAILURE ASSESSMENT
not used as often
Is the patient in the ICU?
Altered Mentation
Respiratory rate (breaths per minute)
Systolic blood pressure
score of 2 = risk of sepsis
Diagnosing infection
Lab//
• microbiology - blood, stool, urine, wound, tissue cultures
- WCC
- CRP
- Platelets
Management
Remove as much pus as possible
Supportive management//
> fluids > analgesia > need for surgery > VTE prophylaxis > O2 > Electrolyte balance > Need for transfusion
+ abx management (huge factor)
Empiric Policy Intra Abdominal Sepsis
Amoxicillin + Gentamicin + metronidazole
Management of abscesses
> Remove source control
Surgery
Remove pus so you remove bacteria
Septic shock
Hypotensive, tachycardia
If urine output is still low despite loads of fluid - be WORRIED
Organ dysfunction because of bacteraemia
SEPTIC 6 BUNDLE
- “BUFALO”
How many hours?
• BLOOD
(blood cultures, blood counts)
• URINE
(monitor accurate hourly urine output - kidney perfusion)
• FLUIDS
(500ml saline STAT)
• ANTIBIOTICS
(IV abx)
• LACTATE
(measure lactate and FBC, higher lactate may require higher level of care)
• OXYGEN
(start high flow oxygen)
Record sepsis goals - the first 6 HOURS.
