Sepsis

Question 1

Sepsis risk factors

Answer 1

Age 65 +

Chronic medical conditions
(Diabetes, lung, cancer, kidney)

Weakened immune systems

Neonates

Question 2

Clinical definition of sepsis

Answer 2

• Presumed source of infection

+ 2 or more SIRS criteria

Question 3

SIRS criteria

Answer 3

T: > 100.4 or < 96.8

RR: > 20

HR: > 90

WBC: > 12,000, or < 4,000, or > 10% BANDs

PCO2 < 32mmHg

Question 4

Severe sepsis =

Answer 4

Sepsis + organ disfunction

SBP < 90

Lactate > 4

Question 5

Signs of end organ damage

Answer 5

Lactate > 2

Platelets, < 100,000

Liver: INR > 1.5 PTT > 60

Altered Mental Status

SBP < 90mmHg

Cr > 2

Question 6

Septic shock =

Answer 6

Severe sepsis (sepsis + organ damage)
with persistent

• signs of end organ damage
• hypotension
• lactate > 4

Question 7

Severe sepsis and Septic Shock bundle: within 3 hours of presentation

Answer 7

1. Lactate level
2. Blood culture prior to antibiotics
3. Antibiotics
4. IV fluids, 30 mL/kg

Question 8

Severe sepsis bundle: within 6 hours of presentation

Answer 8

1. Repeat serum lactate if initial lactate was > 2

Question 9

Septic shock bundle: within 6 hours of presentation

Answer 9

1. Repeat volume status and tissue perfusion assessment

2. Vasopressor administration (if hypotension persists after fluids)

Question 10

Top 2 locations of infection that lead to sepsis

Answer 10

1. Lungs

2. Urinary tract / kidney

Question 11

6 “signs and symptoms” of sepsis

Answer 11

1. Shivering fever, or feeling very cold
2. Extreme pain or discomfort
3. Clammy or sweaty skin
4. Confusion / disorientation
5. SOB
6. High HR

Question 12

Sepsis is now defined as:

Answer 12

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