Sepsis Flashcards
What is sepsis?
A life-threatening organ dysfunction caused by the dysregulated host response to infection.
What is septic shock?
Subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality
What are the diagnostic criteria for septic shock?
Sepsis AND despite adequate volume resuscitation both of:
Persistent hypotension requiring vasopressors to maintain MAP greater than or equal to 65 mmHg AND lactate greater than or equal to 2
What is the SIRS criteria?
Temp over 38
HR over 90
RR over 20
WBC over 12,000 or under 4,000
What is qSOFA?
RR over 22
sBP under 100 mmHg
Altered GCS
Define the criteria for sepsis?
News over 5 with an infection (cough, dysuria, abdo pain, abnormal bloods, new confusion)
What are complications of sepsis?
Liver dysfunction Kidney - AKI or poor urine output CV compromise - tachycardia or hypotension ARDS Confusion, reduced consciousness
When should vasopressors be given in sepsis?
If the patient is hypotensive during or after fluid resuscitation to maintain MAP >65 mmHg
What is the vasopressor of choice in sepsis?
Noradrenaline
When should oxygen be given in sepsis?
Titrate to 94-98%
If concerned measure ABG for both oxygenation and metabolic dysfunction
What antibiotics should be given in sepsis?
Attempts should be made to localise the infection and prescribe
If there is no source - amox, met and gent
If it looks like CAP: co-amoxiclav and doxycycline
What fluids should be prescribed in sepsis?
250-500mls over 15 mins (crystalloid 0.9% saline or hartmann’s)
Aim for a MAP >65 mmHg
Aim for 30ml/kgs over 3 hrs
If there is a lack of response, transfer to HDU for vasopressors
What is a high lactate associated with?
Hypoperfusion and a higher mortality
How much urine is wanted in sepsis?
0.5ml/kg/hr
What are concerning signs in sepsis in hours 2-6?
New confusion
High RR - metabolic acidosis
Low BP
Low BM
