Sepsis

Question 1

What is qSOFA?

Answer 1

Altered mental status (GCS <15)

Fast respiratory rate (>22)

Low blood pressure = 100mmHg)

Question 2

What is the sepsis 6 bundle?

Answer 2

Oxygen (target 94-98% unless COPD target or severe sepsis)

Fluid resuscitation

Blood culture ( and other cultures)

IV antibiotics

Lactate (FBC and biochemistry)

Monitor urine output (catheterise if <60ml at 2 hours)

Question 3

What systolic BP would suggest organ dysfunction?

Answer 3

<90mmHg or MAP <65mmHg

or systolic 40mmHg below patients normal

Question 4

What urine output would suggest organ dysfunction?

Answer 4

<30ml/hr for 2 hours

Question 5

What lactate would suggest organ dysfunction?

Answer 5

> 4mmol/l

Question 6

What serum creatinine would suggest organ dysfunction?

Answer 6

> 150mmol/l

Question 7

Describe fluid resuscitation

Answer 7

Crystalloid/colloid

Initial bolus 500ml then up to 40ml/kg during initial resuscitation

Question 8

Over what period should sepsis 6 be delivered?

Answer 8

1 hour

Question 9

Which vasopressors can be used?

Answer 9

Noradrinaline
Adrenaline
Vasopressin

Question 10

What is sepsis?

Answer 10

Dysregulated host response to infection

Question 11

What is septic shock?

Answer 11

subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality

Sepsis AND (despite adequate volume resuscitation) both of
persistent hypotension
lactate >2mmol/l

Question 12

What is neutropenic sepsis?

Answer 12

chemotherapy has altered how they relate to pathogens

Question 13

Where are gram positive organisms found?

Answer 13

skin and mucous membranes
pneumonia
sinusitis
cellulitis
osteomyelitis
wound infection 
line infection

Question 14

Where are anaerobes found?

Answer 14

mouth, teeth, throat, sinuses and lower bowel 
abscesses
dental infections
peritonitis
appendicitis

Question 15

Where are atypical organisms found?

Answer 15

chest and GI
pneumonia
urethritis
PID

Question 16

Where are gram -ve organisms found?

Answer 16

GI tract
UTI
peritonitis
biliary infection 
pancreatitis 
PID