Sepsis

Question 1

what are the differential impressions

Answer 1

1. sepsis qsofa
2. septic shock-distributive shock ( map <65)
3. pneumosepsis
4. meningeal sepsis
5. gasto-intestinal sepsis
6. septicemia
7. urosepsis
8. skin wound sepsis

Question 2

Basic life support actions # 1

Answer 2

universal care guidlines

Question 3

Basic life support actions # 2

Answer 3

patient saftey line

Question 4

Basic life support actions # 3

Answer 4

exposure emergencies / hypothermia guideline as necessary / indicated

Question 5

if hyperthermic what should you not do?

Answer 5

attempt to cool- fever fights the infection

Question 6

what should you do if hyperthermic and why

Answer 6

hiblers method to preserve body heat because cold blood does not clot.

Question 7

Basic life support actions # 2

Answer 7

complete sepsis alert checklist

Question 8

what is considered a sepsis alert?

Answer 8

sepsis checklist ( qsofa+etco2)

Question 9

what reduces mortality in sepsis?

Answer 9

early recognition and goal directed therapy

Question 10

Advanced life support actions/ considerations # 1

Answer 10

cpap 5-15

• used to maintain spo2 of 94 %
• use with caution its contraindicated in hypoperfused conditions

Question 11

Advanced life support actions/ considerations # 2

Answer 11

fluids 20 ml/ kg over 60 minutes

pedi : same

Question 12

What is first line therapy for hypotension shock?

Answer 12

Mean arterial preasure 7o-110

Fluid is paramount for survial; do not withold for normotensive patients

Question 13

Advanced life support actions/ considerations # 3

Answer 13

epi .2-.5 mcg/kg/min iv io infusionas necessary / indicated

Question 14

what is second line therapy for hypotension shock

Answer 14

EPI

target map to 70-110

initate only after 2 L of fluids infused

Question 15

Medical control actions/ orders / request for

Answer 15

pedi epi .1-1mcg/ kg/ min iv/ io infusion

Question 16

What are the main 3 elements needed for calling a sepsis alert?

Answer 16

1. Infection
2. sepsis
3. hypocapnea

Question 17

What are you looking for when evaluation of infection?

Answer 17

suspeced or known: look for

• fever
• uti/uri symptoms
• taking antibiotics, visible

Question 18

what are you looking for when evaluation of sepsis?

Answer 18

1. Altered mental status
2. tachypnea
3. hypotension

• confused off normal baseline,lethargy
• RR greater or equal to 22min
• Systaloic bp< 100, considered lower than normal

Question 19

what are you looking for with capnograpphy?

Answer 19

Hypocapnea

ETco2 less than or equal to 29