Sepsis 6

Question 1

what is sepsis?

Answer 1

life-threatening organ dysfunction caused by a dysregulated host response to infection

Question 2

what is septic shock?

Answer 2

circulatory and cellular/ metabolic dysfunction

presence of sepsis + persistent hypotension <65mmHg and a lactate >2mmol/L

Question 3

what can a simple infection lead to?

Answer 3

sepsis > septic shock

Question 4

can you have sepsis without an infection?

Answer 4

no

Question 5

what is infection?

Answer 5

invasion and multiplication of microorganisms in the body

Question 6

causes of infection

Answer 6

bacteria
viruses
fungi
parasites

Question 7

two types of infection

Answer 7

1. localised e.g. abscess

2. disseminated e.g. bacteraemia

Question 8

do some bacteria live locally?

Answer 8

yes and cause no damage

Question 9

what is include in the sepsis 6?

Answer 9

1. oxygen
2. fluid resuscitation
3. blood cultures
4. IV antibiotics
5. lactate
6. UO

Question 10

when should sepsis 6 be done?

Answer 10

within 1 hour of suspected sepsis in a patient

Question 11

when should oxygen be given?

Answer 11

saturations below 94%

Question 12

what fluid resuscitation is given?

Answer 12

0.9% saline IV as 500mls bolus

Question 13

what blood cultures are taken?

Answer 13

one culture is enough

Question 14

what blood cultures are taken if endocarditis is suspected?

Answer 14

3 within 1 hour before antibiotics (Duke’s criteria)

Question 15

are blood cultures taken before IV antibiotics in sepsis 6?

Answer 15

no

Question 16

when should you start IV antibiotics in sepsis?

Answer 16

immediately

Question 17

how do you decide which prophylaxis antibiotics to use?

Answer 17

site
PMH
RF

Question 18

what do large abscesses need?

Answer 18

drainage as no blood supply so antibiotics do not target well

Question 19

what does a high lactate indicate?

Answer 19

hypoperfusion

Question 20

what is the sepsis 6 referred to as?

Answer 20

take 3

give 3

Question 21

what should you do in hours 2-6 of a septic patient?

Answer 21

• continue resuscitation= MAP >65 and UO >0.5ml/kg/hr
• regular review
• improve NEWS
• haemodynamically stable
• reduce lactate

Question 22

scoring systems for sepsis

Answer 22

SEWS
SIRS
SOFA
qSOFA
NEWS

Question 23

what is SIRS

Answer 23

systemic inflammatory response system

no longer used

Question 24

what is SOFA?

Answer 24

scoring system that is too long winded so have been shortened to qSOFA

Question 25

what is qSOFA

Answer 25

screening for outcome

includes RR >22, SBP <100 and altered GCS

Question 26

what NEWS score should make you think sepsis?

Answer 26

5 or more (only if they have infection)

Question 27

NEWS score actions

Answer 27

0= continue routine monitoring
1-4= monitor 4-6 hourly
3 in one category= hourly monitoring
5 or more= urgent response
7 or more= emergency

Question 28

when to consider sepsis?

Answer 28

do they look ill?
early warning score?
signs of infection?

Question 29

what is Occam’s razor?

Answer 29

simplest explanation is usually right

Question 30

risk factors for sepsis

Answer 30

very young <1
very old >70
immunosuppressed
pregnancy (including post-partum, post-TOP and post-miscarriage)