SEPSIS Flashcards
1
Q
define colonsation
A
the presence of a microbe in the human body without an inflammatory response
2
Q
define infection
A
inflammation due to a microbe
3
Q
define bacteraemia
A
the presence of viable bacteria in the blood
4
Q
define sepsis
A
life-threatening organ dysfunction caused by a dysregulated host response to infection
5
Q
define septic shock
A
- Subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality.
- There must have been adequate attempts at resuscitation
6
Q
name 4 risk factors for sepsis
A
- <1 year and >75 years
- recent trauma/surgery or invasive procedure
- impaired immunity due to illness (eg DM) or drugs (eg long term chemo or IS)
- any breach of skin integrity ( eg cut, burn, blister, skin infection), indwelling lines and catheters
7
Q
correction of hypotension
A
- fluid resuscitation
- if required inotropes and vasoconstrictors can be used
8
Q
use of inotropes
A
- eg nor/adrenaline
- cause vasoconstriction ± increase myocardial contractility
- indicated when there is persistent hypotensiondespite optimized fluid resuscitation/euvolaemia restored
9
Q
shock liver
A
- acute liver injury caused by hypoperfusion
- can cause transaminitis (grossly elevated ALT/AST in blood stream) and jaundice due to hepatocyte injury
10
Q
CNS features of sepsis
A
- delirium/acute confusional state due to diffuse cerebral hypoperfusion/dysfunction
- drowsiness and decreased conscious level
11
Q
how can lactic acidosis occur in sepsis
A
- type A (due to tissue hypoxia)
- diffuse tissue hypoxia results in anaerobic metabolism (lactic acid is the end product of anaerboic metabolism of glucose)
12
Q
what effect does metabolic acidosis have on CV stability
A
worsens it
13
Q
haematological effects of sepsis
A
- disseminated intravascular coagulation: small clots form throughout the blood stream blocking small blood vessels
- increased clotting decreases platelets and clotting factors needed to control bleeding
14
Q
evidence of DIC
A
- low platelets
- prolonged APTT/PT
- low fibrinogen
15
Q
SIRS criteria
A
16
Q
what else can cause SIRS
A
NO INFECTION - NOT SEPSIS
18
Q
qSOFA score
A
- identifies high risk patients for in-hospital mortality with suspected infection
- ≥2 qSOFA score and the likelihood of infection is assocated with a greater risk of death/prolonged ITU stay
19
Q
GCS
A
<14 needed for qSOFA
21
Q
SEPSIS 6 BUNDLE
A
