Sepsis Flashcards
What is sepsis?
Organ dysfunction due to dysregulated response to infection
What is SIRS?
Systemic inflammatory response syndrome
What are the sepsis criteria?
SIRS criteria + source of infection
What are the SIRS criteria?
Temp >38 HR >90 RR >20 WCC >12 Glucose >7.7 in a non-diabetic Drowsy/confused
What bedside tests can you do to find infection source?
Urine dipstick CXR Sputum sample Stool sample Skin/wound swab AVPU
What are the sepsis red flags?
Responds only to voice or pain Acute confusional state SystoliBP <90 HR >130 RR >25 Needs to maintain sats above 92% Urine output <0.5ml/kg/hr Lactate >2 Recent chemotherapy
What is septic shock?
Severe sepsis with hypotension
What mediators amplify a systemic inflammatory response?
Nitric oxide - vasodilation Bradykinin - vasodilation Complement proteins - inflammation Thrombin - clotting Interleukins - inflammation TNF - inflammation
What is the pattern on an ABG in sepsis?
Metabolic acidosis
Why does sepsis cause tachypnoea?
Metabolic acidosis
Need to reduce CO2 - compensate acidosis
Increase RR to blow off CO2
Where do you check cap refill in sepsis?
Centrally on sternum
Why do you take lactate?
Cryptic shock
Predicts outcome - decision for ITU
Should reduce with fluids
What is cryptic shock?
Serum lactate greater than 4 mmol/L with a systolic blood pressure of at least 90mmHg
What is the sepsis 6?
IV fluids O2 Broad spectrum antibiotics Take cultures Take lactate Urine output
What antibiotic is used in chemo patients?
Tazocin
