Sepsis Flashcards

1
Q

Types of infection

A

Bacterial, fungal, parasitic, viral

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2
Q

Infection emergency

A

Cause adverse outcome to patient

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3
Q

Infection control emergency

A

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

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4
Q

Infection triggers

A

A complex, variable, and prolonged host response

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5
Q

Sepsis

A

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

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6
Q

Trigger fro sepsis spectrum

A

Infection/ trauma

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7
Q

First non specific response in sepsis

A

Systemic inflammatory response syndrome

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8
Q

SIRS must have what

A

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

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9
Q

Severe sepsis is

A

Sepsis with more than one sign of organ failure

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10
Q

Sepsis defining criteria

A

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

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11
Q

Septic shock

A

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

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12
Q

Microbial components that trigger shock

A

Endotoxins - gram negative

Lipoteichoic acid- gram positive

Direct - vascular endothelium

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13
Q

Superantigen cause ?

A

Much faster much more prolonged response to infection

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14
Q

Main causes of infection - related shock and morality

A

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

Gram positive,

Staph aureus, group A strep, strep pneumonia, clostridium

Parasites

Fungi

Viruses

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15
Q

Most common conditions associated with septicaemia and shock

A

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

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16
Q

Diagnosis of sepsis

A

Clinical according to sepsis criteria

Specific cause- determine origin

Blood cultures

Other lab tests

17
Q

Why conditions must be differentiated from sepsis

A

Sepsis needs antibiotics to treat unlike other conditions

18
Q

Management of sepsis

A

Fluids, dopamine, transfusion ICU

Resolution of precipitating problems

Monitor : blood gas , renal function, cns,

Antimicrobials

19
Q

Outcomes of sepsis

A

Multi organ failure

Amputations
Prolonged hospital stay

Morality 30-60%

20
Q

SSC guidelines are

A

Gold standard of care

21
Q

How many people does sepsis affect / kill

A

Affects millions

Kills 1/4

22
Q

Sepsis 6 is

A

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

23
Q

What do you need to deliver sepsis 6

A

Patient with sepsis

Qualified prescriber

Basic healthcare equipment

24
Q

Steps of sepsis 6

A

Administer high flow oxygen

Take blood cultures

Give broad spectrum antibiotics

Give intravenous fluid challeneges

Measure serum lactate and haemoglobin

Measure hourly urine output

25
Sepsis 6 has what benefit
Doing it in first hour you double chance of patient surviving
26
SSC antimicrobial recommendations
Begin IV antibiotics early (within on hour) of septic shock Start with broad spectrum antibiotics then declassify
27
Typical antimicrobial therapies- community acquired infection shock Origin unknown or ...
Gut or renal or binary Coxamoxiclav + gentamicin Or (x) + metronidazole + gentamicin
28
Skin and soft tissue infection treatment
Flucloxacillin + penicillin/amoxicillin+ gentamicin
29
Pneumonia treatment
Co-amoxiclav + doxycycline Or Cefuroxime+ erythromycin
30
Meningococcal disease treatment
Penicillin or ceftriaxone
31
Malaria treatment
Quinine
32
Penicillin or cephalosporin allergy Rash only If severe
Rash only- penicillin or cephalosporin depending on allergy If severe- ciprofloxacin, vancomycin,erythromycin
33
Hospital acquired infection shock (late)
Gentamicin + piperacillin-tazobactam
34
Adjunctive measures
```  Remove infected catheters and devices  Drain pus, debride dead tissue  Consider lessening immunosuppression therapies  Fluid balance etc ```  Check gentamicin or vancomycin levels