Sepsis

Question 1

Types of infection

Answer 1

Bacterial, fungal, parasitic, viral

Question 2

Infection emergency

Answer 2

Cause adverse outcome to patient

Question 3

Infection control emergency

Answer 3

Rapid reads,is Simon to many people in short space of time

Question 4

Infection triggers

Answer 4

A complex, variable, and prolonged host response

Question 5

Sepsis

Answer 5

Is the body’s overwhelming and life threatening response to infection that can lead to tissue damage, organ failure and death

Question 6

Trigger fro sepsis spectrum

Answer 6

Infection/ trauma

Question 7

First non specific response in sepsis

Answer 7

Systemic inflammatory response syndrome

Question 8

SIRS must have what

Answer 8

2 or more of the following

Temperature 38 or more/ 36 or less

HR >90 beats per minute

Respirations 20/min

WBC count > 12000/mm3

Question 9

Severe sepsis is

Answer 9

Sepsis with more than one sign of organ failure

Question 10

Sepsis defining criteria

Answer 10

At least 2 SIRS criteria caused by known or suspected to be infectious

Question 11

Septic shock

Answer 11

Sepsis with persistent or refracrionary hypotension or tissue hypoperfusion despite adequate fluid resusicitation

Question 12

Microbial components that trigger shock

Answer 12

Endotoxins - gram negative

Lipoteichoic acid- gram positive

Direct - vascular endothelium

Question 13

Superantigen cause ?

Answer 13

Much faster much more prolonged response to infection

Question 14

Main causes of infection - related shock and morality

Answer 14

Gram negative - E.coli, other Califorms, meningococcai, pseudomonas,haemophilus

Gram positive,

Staph aureus, group A strep, strep pneumonia, clostridium

Parasites

Fungi

Viruses

Question 15

Most common conditions associated with septicaemia and shock

Answer 15

Severe UTI with pyelonephritis  Meningococcal disease  Gut perforation 
Infection of intravenous catheters and devices 
Skin and soft tissue infection  Endocarditis 
Pneumonia 
Chlolecystitis /Cholangitis / Pancreatitis

Question 16

Diagnosis of sepsis

Answer 16

Clinical according to sepsis criteria

Specific cause- determine origin

Blood cultures

Other lab tests

Question 17

Why conditions must be differentiated from sepsis

Answer 17

Sepsis needs antibiotics to treat unlike other conditions

Question 18

Management of sepsis

Answer 18

Fluids, dopamine, transfusion ICU

Resolution of precipitating problems

Monitor : blood gas , renal function, cns,

Antimicrobials

Question 19

Outcomes of sepsis

Answer 19

Multi organ failure

Amputations
Prolonged hospital stay

Morality 30-60%

Question 20

SSC guidelines are

Answer 20

Gold standard of care

Question 21

How many people does sepsis affect / kill

Answer 21

Affects millions

Kills 1/4

Question 22

Sepsis 6 is

Answer 22

St of interventions which can be delivered by a junior healthcare professional in a team

Question 23

What do you need to deliver sepsis 6

Answer 23

Patient with sepsis

Qualified prescriber

Basic healthcare equipment

Question 24

Steps of sepsis 6

Answer 24

Administer high flow oxygen

Take blood cultures

Give broad spectrum antibiotics

Give intravenous fluid challeneges

Measure serum lactate and haemoglobin

Measure hourly urine output

Question 25

Sepsis 6 has what benefit

Answer 25

Doing it in first hour you double chance of patient surviving

Question 26

SSC antimicrobial recommendations

Answer 26

Begin IV antibiotics early (within on hour) of septic shock

Start with broad spectrum antibiotics then declassify

Question 27

Typical antimicrobial therapies- community acquired infection shock

Origin unknown or …

Answer 27

Gut or renal or binary

Coxamoxiclav + gentamicin

Or (x) + metronidazole + gentamicin

Question 28

Skin and soft tissue infection treatment

Answer 28

Flucloxacillin + penicillin/amoxicillin+ gentamicin

Question 29

Pneumonia treatment

Answer 29

Co-amoxiclav + doxycycline

Or

Cefuroxime+ erythromycin

Question 30

Meningococcal disease treatment

Answer 30

Penicillin or ceftriaxone

Question 31

Malaria treatment

Answer 31

Quinine

Question 32

Penicillin or cephalosporin allergy

Rash only

If severe

Answer 32

Rash only- penicillin or cephalosporin depending on allergy

If severe- ciprofloxacin, vancomycin,erythromycin

Question 33

Hospital acquired infection shock (late)

Answer 33

Gentamicin + piperacillin-tazobactam

Question 34

Adjunctive measures

Answer 34

 Remove infected catheters and devices 
 Drain pus, debride dead tissue 
 Consider lessening immunosuppression
therapies 
 Fluid balance etc 

 Check gentamicin or vancomycin levels