Sepsis

Question 1

What is the name for sepsis when it develops in a pregnant woman?

Answer 1

Maternal Sepsis

Question 2

What is postpartum or peurperal sepsis?

Answer 2

Sepsis which develops within 6 weeks after delivery

Question 3

What is sepsis?

Answer 3

Dysregulated immune response triggered by an infection which causes injuries to the host’s own tissues and organs

Question 4

What are 9 clinical signs?

Answer 4

1. pyrexia or hypothermia
2. tachycardia (>100 bpm)
3. tachypnoea (abnormally rapid breathing)
4. hypotension (low blood pressure)
5. if pregnant - fetal heart rate >160bpm
6. altered mental state
7. oliguria (less than 400-400mL per 24 hours)
8. jaundice
9. unwell

Question 5

What is the treatment for early sepsis detection and vital organs aren’t affected?

Answer 5

antibiotics

Question 6

What is the ‘sepsis six’?

Answer 6

1. ensure oxygen saturations >94%, give oxygen if required
2. take blood cultures/samples for culture (if facilities not available to take blood cultures DO NOT let this delay administration of antibiotics)
3. give IV antibiotics
4. give IV fluids
5. take blood for lactate, glucose, FBC, U&Es, creatinine and clotting
6. measure urine output

Question 7

What is septic shock?

Answer 7

specific form of shock where there is disruption in the vasodilatory ability of the body.
Defined as hypotension that persists even with adequate fluid resuscitation

Question 8

Always ensure women know the signs of infection - what are they?

Answer 8

fever, shivering, abdominal pain or offensive vaginal loss - seek emergency treatment if present

Question 9

What needs to be done if a woman appears or reports to be unwell?

Answer 9

1. full set of vital signs (MEOWS) - pulse, BP, respiratory rate, level of consciousness, oxygen saturation and temperature

Question 10

What do you use to determine if a woman has sepsis?

Answer 10

Sepsis screening tool

Question 11

What is a sepsis screening tool?

Answer 11

The Red flag sepsis or high risk criteria

Question 12

What does it mean if there are high triggers present in the sepsis screening tool?

Answer 12

high risk of deterioration and highly likely that there is organ dysfunction

Question 13

What are red flat sepsis or high risk criteria triggers? (10)

Answer 13

1. responds only to voice or pain\unresponsive
2. acute confusional state
3. systolic BP < or same as 90mmHg (or dropped by 40 from normal)
4. heart rate >130 bpm
5. respiratory rate > =25 pm
6. needs oxygen to keep Sp02>= 92%
7. non-blanching rash, mottled/ashen/cyanotic skin
8. not passed urine in last 18 hours or urine output <0.5 ml/kg per hour
9. lactate >= 2mmol/l
10. recent chemotherapy

Question 14

When do you declare red flag sepsis?

Answer 14

woman has 1 or more triggers

Question 15

what is the amber flag or moderate to high risk criteria sepsis screening tool?

Answer 15

used to identify women with a moderate to high risk of deterioration that may warrant further investigation to determine if this is sepsis