Sepsis

Question 1

Septicemia

Answer 1

Pathogen has entered the bloodstream

Blood poisoning

Question 2

Sepsis

Answer 2

When you have SIRS plus a cause of some kind of infection

Question 3

Severe Sepsis

Answer 3

When you have SIRS plus infection and now problems with blood pressure

Question 4

Septic Shock

Answer 4

Distributive Shock

Everything plus decreased tissue perfusion and even lower blood pressure

Question 5

Local Signs and Symptoms of Infection

Answer 5

Heat
Edema
Erythema
Loss of Function
Pain
Purulent Drainage

Question 6

Local Signs and Symptoms of Inflammation

Answer 6

Heat
Edema
Erythema
Loss of Function
Pain

Question 7

Systemic Signs and Symptoms of Infection

Answer 7

Fever, chills
Leukocytosis
Aches, weakness
Nausea, vomiting

Question 8

Systemic Signs and Symptoms of Inflammation

Answer 8

Fever
Leukocytosis
Malaise
Anorexia
Nausea, vomiting
Lymph node enlargement

Question 9

Systemic Inflammatory Response Syndrome Criteria

Answer 9

Two or More:

Respiratory rate > 20 per minute; PaCO2 < 32mmHg

Temperature < 36 degrees or < 38 degrees Celsius

Heart rate > 90 beats per minute

WBC count < 4,000 or > 10,000 cells/mm3

Question 10

SIRS Symptoms

Answer 10

Decreased urine output

Decreased skin perfusion, poor capillary refill

Skin mottling

Decreased platelet count, petechiae

Hypoglycemia

Chills, unexplained change in mental status

Question 11

Severe Sepsis/Septic Shock leads to…

Answer 11

Hypotension

Hypoperfusion (Lactate > 3 mmol/L)

Organ dysfunction

SpO2 < 90%

Altered mental status

Output of less than 0.5 mL/kg/hour

Platelets less than 100,000

Elevated bilirubin

Question 12

High Risk Factors for Sepsis

Answer 12

Age > 65 years or < 1 year old

Black men

Those with infections of the lung, urinary tract, skin, and gut

Infections caused by Staph, E. coli, and Strep

Comorbidities of pulmonary, renal, cardiovascular disease, diabetes, hypertension, and immunosuppression

Question 13

Assessment

Answer 13

Monitor trends in vital signs

Look for changes in mental status

Watch for swelling in the body/positive fluid balances

Listen to the lungs and monitor saturation levels

Assess drainage, development of ulcers, degree of cellulitis

Question 14

Fluid Resuscitation

Answer 14

Blood transfusion as needed

Blood pressure monitoring goal MAP of > 65 mmHg

Venous oxygen saturation via a central venous catheter

Dobutamine and norephinephrine for inotropic and vasoactive support

Question 15

Treatments

Answer 15

Urine output monitoring

Blood cultures

Antibiotic therapy

Blood monitoring (lactate, hemoglobin, urine, glucose, electrolytes, liver function tests)