Sepsis Flashcards
describe fever
- natural response to infection
- treated if >100.7-101
- fever at 106 will start to kill you
- fever at 107 is brain damage
what is sepsis protocol
- catch early
- watch for increased temp
- watch for elevated lactate levels
- decreased BP
why does lactic acid increase in sepsis
d/t anaerobic environment
goes off puruvite cycle
lactate >2 is a problem, should be closer to 0
what is the process of sepsis
1) infection (fever, chills, malaise)
2) SIRS (all over generalized complaints)
3) shock (decreased BP, tachypnea, and tachycardia)
4) MODS
5) death
what is shock broken down into
warm (DIC)
cold (ARDS)
describe SIRS
- releases products (histamine and natural killer cells) and inflame body
- start to dilate everything out
- vessels open up so products can be released (increase in vascular bed)
- BP begins to drop
s/s of SIRS
- hypotension
- tachycarida
- tachypnea
- oliguria
- hypoxia
- hypercapnia
- seizures/coma
describe distribute shock
- caused by increase in permeability
- loss of sympathetic tone
- neural and chemical (2 types)
describe anaphylaxis
- immediate allergic reaction
- rapid release of products
- anoxic period
- shuts off bronchial tubes
- whole body response
- can lead to decreased cardiac conductinon, dysrhythmias, bronchial edema, hypoxia, and death
what does SIRS lead to
DIC
what is the process of septic shock
inflammation (vasodialtion) tissue damage (ischemia and DIC) ARDS MODS death
what is DIC
disseminated intravascualr coagulation
- small clots form d/t toxins and inflammation in order to stop infectious process
- causes platelets to be used up, pt can have massive bleeding (under skin/bruising)
- as inflammation continues, capillaries leak, fluid shifts from vessel to interstitial space and BP drops leading to shock
what are the indicators of DIC
- BP drops dramatically
- start to see things bleed (IV site and nose)
what drugs are given for DIC
- heparin to bring clotting cascade back to normal
- norepinephroine (vasoconstrict and increase HR and BP)
- vasopressin (helps hold in fluid, clamps off bleeding)
if heparin doesnt work for DIC give what
-platelets and clotting factors (FFP, 6 pack of platetlets, factor 7 or 10)
