Sepsis

Question 1

How would you define sepsis ?

Answer 1

A life-threatening organ dysfunction caused by dysregulation host response to infection.

Question 2

What common organ dysfunction occurs in sepsis ?

Answer 2

Arterial hypoxaemia
Oliguria
Increase in creatinine 
Ileus
Hyperbilirubinaemia

Question 3

What are the signs and symptoms of sepsis in an adult ?

Answer 3

Shivering 
Rigors
Extreme discomfort
Disorientation and confusion.
SOB
Tachycardia
Hypotension
Decreased output.

Question 4

What investigations would need to be done in adult sepsis ?

Answer 4

Take 3:
Blood cultures
Blood lactate
Monitor urine output

Question 5

What is the treatment for adult sepsis ?

Answer 5

Give 3:
Oxygen
IV Antibiotics
IV fluids (Fluid challenge)

Find the source

Question 6

What are the signs and symptoms in sepsis in an infant or child ?

Answer 6

Mottled skin
Non-fading rash when pressed.
Increased respiratory rate.
Convulsions.
Bulging fontanelle. 
Poor feeding
Floppy.
Lethargic.
Cold to touch.

Question 7

What would be the investigations in sepsis in an infant or child ?

Answer 7

Include someone more senior.
CXR - Find cause
Blood gas
Blood culture
Vital signs

Question 8

What is the treatment for an infant or child with sepsis?

Answer 8

IV Fluids
IV Pen and Gent
Oxygen
Nutrition and Hydration

Question 9

When in adult sepsis should you consider HDU referral ?

Answer 9

Hypotensive
Lactate > 2 despite fluid restriction. 
Elevated creatinine
Oliguria
Liver dysfunction

Question 10

When in adult sepsis should you consider ITU ?

Answer 10

Septic shock
Multi-organ failure
Requires sedation, intubation or ventilation.