Sepsis Flashcards
Define sepsis
life-threatening organ dysfunction caused by dysregulated host response to infection
Define septic shock
identified with a clinical construct of sepsis with persisting hypotension requiring vasopressors to maintain MAP >65mmHg and having a serum lactate of >2mmol/l despite adequate volume resuscitation
What is the mortality rate for septic shock?
40%
Describe how qSOFA can be used to predict outcomes for patients with sepsis
- Hypotension; systolic BP < 100 mmHg
- Altered mental status
- Tachypnea; respiratory rate > 22 breaths/min
A score of ≥2 suggests a greater risk of a poorer outcome.
What are the three phases of sepsis pathophysiology?
- Release of bacterial toxins
- Release of mediators
- Effects of specific excessive mediators
Outline the principles of clinical management of sepsis using Sepsis 6
Sepsis six; take 3, give 3:
Take blood cultures, blood lactate and urine output.
Give oxygen (aim for sats 94-98%), IV antibiotics and IV fluid challenge.
Should all be done within the first hour.
What fluids should be given to a patient with sepsis?
IV fluids: 30ml/kg fluid challenge (expert opinion). 2.1L 70kg patient (30ml crystalloid per kg).
Describe the use of empiric antimicrobial therapy in patients presenting with sepsis and in whom there is no positive microbiology
Amoxicillin, Gentamicin and Metronidazole are empirical antibiotics for suspected sepsis (broad-spectrum for gram-negative infections). For each hour’s delay in administering antibiotics in septic shock, mortality increases by 7.6%.
