Sepsis Flashcards
1
Q
What is sepsis?
A
- it is a condition triggered by an infection
- in an attempt to overcome the infection our bodies release a battery of chemicals and hormones causing inflammation and send white blood cells to fight the invading organisms
- thought of as the body’s severe response to an infection rather than a severe infection
- microorganisms are usually but not exclusively bacteria
2
Q
Define sepsis
A
- condition triggered by an infection
3
Q
Define SIRS
A
- systemic inflammatory response syndrome
4
Q
Define septic shock
A
- sepsis induced hypotension (<90 mmHg or a reduction of 40 mmHg)
5
Q
Define severe sepsis
A
- sepsis associated with acute organ dysfunction
6
Q
Define septicaemia
A
- the presence in the blood of large numbers of bacteria and their toxins
7
Q
Define MODS
A
- multiple organ dysfunction syndrome
8
Q
Describe the continuum of illness due to infection
A
Bacteremia —> Septicaemia —> Sepsis —> Severe Sepsis —> severe sepsis with septic shock —> MODS —> death
9
Q
Describe the pathophysiology of sepsis
A
- the following chemicals are thought to cause the ‘damage’
- endotoxins —> lipoproteins contained within gram - neg organisms
- exotoxins —> products of microorganisms - harmful to host
- host - mediators —> cytokines including tumour necrosis factor, interleukin 1,6,8 and myocardial depression factor
10
Q
What are the effects of systemic infection?
A
- inappropriate fluid shift and vasodilation compromising tissue perfusion
- impaired tissue oxygenation, hypoxia, acidosis (disturbed pH, may be characterised by vomiting, tachypnoea, drowsiness), hypotension and hypovolaemia
- at cell level, reduced oxygenation and perfusion ends to falling adenosine triphosphate (ATP) levels and loss of cell membrane integrity
- despite the body compensating by increasing cardiac output, this rise fails to meet metabolic demands or to compensate for the decreased ventricular pre-load leading to end organ subperfusion and failure
11
Q
What are the effects of sepsis?
A
- bacteria enter blood and trigger complex immunologic reactions
- vasodilation occurs and fluid leaks from blood vessels into surrounding tissue
- leaking vessels impair the body’s ability to pump blood (containing vital nutrients) to surrounding tissues and organs
- decreased blood flow to organs results in poor nutrient exchange and tissue swelling
- shock
- MODS
—> kidney failure - kidneys shut down
—> respiratory failure - alveoli collapse and fill with fluid
—> osteomyelitis - infection in bone causes deterioration
—> brain damage - brain swells and is deprived of oxygen
12
Q
What are some of the pre-disposing factors for pregnancy?
A
- initial insults - trauma
- poor infection control policy
- staffing levels
- length of stay
- invasive equipment
- resident populations of microorganisms
- inappropriate antibiotic therapy
- poor nutritional status
13
Q
What are some of the risk factors for sepsis?
A
- c/s
- perineal trauma
- catheterisation
- PROM
- prolonged labour
- obesity
- diabetes
- impaired immunity
- anaemia
- retained products
14
Q
What are some of the common symptoms of sepsis in the puerperium?
A
- fever, rigours
- diarrhoea or vomiting - may indicate exotoxin production
- breast engorgement/ redness/ rash
- abdominal/ pelvic pain and tenderness
15
Q
What are the signs and symptoms of sepsis?
A
- tenderness
- wound infection - spreading cellulitis or discharge
- offensive vaginal discharge
- productive cough
- urinary symptoms
- delay in uterine involution
- general - non specific sign such as lethargy, reduced appetite
