Sepsis Flashcards
How is sepsis diagnosed?
NEWS >5 + infection
What is septic shock?
Continued deterioration and hypotension despite adequate fluid resuscitation
What is the treatment for sepsis and within what timeframe must this be delivered?
Within 1 hour: BUFALO
Blood cultures (+ other cultures - sputum, urine, stool, joint aspirate)
Urine output (use fluid balance chart >0.5ml/kg/hr)
Fluids IV (30ml/kg/hr over 3 hours saline)
Antibiotics (based upon clinical picture)
Lactate measurement (concern if >4mmol/L, remeasure within 2 house (sign of hypo perfusion))
Oxygen (high flow through non-rebreather)
What should be given if patient remains hypotensive after BUFALO?
Vasopressors
What colour are gram +ve and gram -ve bacteria on staining?
Positive = Purple Negative = piNk
What strains of streptococcus undergo beta haemolysis?
Strep pyogenes (GAS) Enterococcus faecalis
Which strains of strep undergo alpha haemolysis??
Strep pneumoniae, Strep viridans,
Ent. faecalis
What drug is used to treat streptococcal infections?
Amoxicillin
What drug is used to treat staph aureus infection?
Flucloxacillin
What drug is used for Staph epidermidis infection and what infection is it indicated in?
Vancomycin Endocarditis (prosthetic valve)
What treatment is used for Ent faecalis and what infections is it indicated in?
UTI, GI infections
Amox + Gent
What infections is Strep pneumoniae indicated in?
Pneumonia, otitis media, meningitis
What is used as an alternative if the patient is allergic to penicillin?
Doxycycline or vancomycin
What bacteria is indicated in throat infections (tonsillitis)?
Strep pyogenes (group A strep)
What is the infecting organism in epiglottitis and how is it treated?
Haem. influenzae
Amoxicillin