sepsis Flashcards
What is Sepsis?
systemic inflammatory reaction to a suspected infection which ultimately can deteriorate to organ failure.
What are the causes of sepsis?
Trauma, indwelling lines, pulmonary, gastrointestinal, wounds, multiple insults.
What are the stages of sepsis?
- Compensated/non-progressive(homeostasis triggered) 2. Decompensated/progressive (systems unable to improve) 3. Irreversible (cells in organs damaged).
Pathophysiology of sepsis:
Cytokines(WBC) and Enzymes(bone marrow)released to fight infection. Enzymes damage endothelial lining, increased inflammatory response, stimulates a pro coagulation state.
excess inflammatory response results in tissue death, circulatory insufficiency and poor oxygen to tissues. body unable to respond to invading pathogens.
Coagulation in sepsis
usually fibrin lytic pathways limit clotting extent, not in sepsis, creates intravascular thrombi= poor oxygen to organs= tissue ischemia and necrosis.
symptom progress
Hypoperfusion9lactic acidosis, Oliguria, Altered mental status, hypotension, impaired homeostasis
Sings and Symptoms
Breathing: stimulations of breathing centre. Circulation: Hypotension, Temp, Tachycardia, Reduced urine, Capillary refill, Disability: Delirium, Rigors.
Sepsis red flag:
Systolic BP: <90, HR: >130, RR: 25, Lactate > 2mmol
what is sepsis sixty minutes?
Fluid bolus, Antibiotics, Blood cultures, Urine output, Lactate and Hb, Oxygen, Sixty minutes
What intervention would you take for sepsis?
Breathing-Oxygen, Circulation- Fluid therapy, Blood test, Vasoactive medication. Disability- Analgesia, Glucose control. Exposure- VTP
what should be completed within 3 hours?
- lactate level, blood cultures, antibiotics, admin of crystalloid for hypotension or lactate.
What should be completed within 6 hours?
apply vasopressors to maintain a mean arterial pressure, re assess, re measure lactate
