Sepsis Flashcards
Define sepsis
When the body’s response to infection causes injury to its own tissues & organs
(SIRS + known or suspected infection)
Define SIRS (systemic inflammatory response syndrome).
Aninflammatory responseto infection (or a non-infectious insult) that affects the whole body
Define severe sepsis.
Sepsis + organ dysfunction (including septic shock)
Describe how pathogenesis of sepsis starts.
Stimulation of immune system - release pro-inflam cytokines
Inc fever, vasodilation, cap permeability, WBC
Hypovalemia, hypotension
Hypoperfusion of tissues
Anaerobic resp/acidosis
Organ failure
To diagnose SIRS, the patient has to have 2 or more of what signs?
temperature <36°C or >38°C
heart rate >90/min
respiratory rate >20/min or pCO2 <32mmHg
WCC <4x109/dl or >12x109/dl or >10% immature WBCs
blood glucose >7.7mmol/l (unless DM present)
confusion or ↓ conscious level (GCS)
What are the red flag features of severe sepsis?
purpuric rash heart rate >130/min systolic BP <90mmHg or mean arterial BP <65mmHg respiratory rate >25/min oxygen saturation <91% ↓ conscious level lactate >2mmol/l
What is the SOFA score?
a comprehensive scoring system used in intensive care
hypoxia / GCS / hypotension / coagulation / bilirubin / renal function
What is the qSOFA score?
qSOFA score = an abbreviated score used in screening for sepsis
(respiratory rate / GCS / systolic blood pressure)
Within one hour of suspecting severe sepsis, what is the sepsis 6 you would use to treat the patient?
- Give high-flow oxygen
- Take blood cultures
- Give empirical IV antibiotics
- Measure FBC & serum lactate
- Start IV fluid resuscitation
- Start accurate urine output measurements
If giving the sepsis 6 treatment, does work, what other things would you try?
Critical care
Resuscitation bundle (Early Goal Directed Therapy) CVP monitoring, vasopressor drugs, inotropic drugs
Steroids/ventilator
Where could you check for sepsis protocols and antibiotic guidelines?
Surviving sepsis campaign
British National Formulary
Local guidelines
