Sepsis

Question 1

What is the sepsis 6?

Answer 1

Management which must be taken if suspicious of sepsis

3 tests:

• Lactate
• Urine output
• Blood cultures

3 treatments

• IV fluid (maintain BP)
• Oxygen
• IV Broad spectrum antibiotics

Question 2

Describe the pathophysiology of sepsis

Answer 2

Increased cytokines from immune response -> increased NO -> increased fluid leaking out vessels -> oedema -> decreased O2 in tissues -> increased lactate

Activation of clotting cascade

• > increased fibrin deposits -> decreased circulation
• > thrombocytopenia (reduced plateletes) -> can’t clot bleeds -> DIC (disseminated intravascular coagulopathy)

Look at nice wee chart in notes

Question 3

What is usually the first indication of sepsis?

Answer 3

A raised resp rate with no clear indication of why

Question 4

What chart is used to manage sepsis risk and what measurements are taken on it?

Answer 4

NEWS

• BP
• RR
• HR
• Confusion
• Temp
• O2 sats

Question 5

What is Bacteraemia?

Answer 5

Presence of bacteria in blood

Question 6

What is SIRS?

What differentates SIRS from Sepsis from Septic shock?

Answer 6

SIRS = systemic inflammatory response syndrome

>2 or more of:
Resp rate >20
HR >90 bpm 
Temp <36 OR >38
High neutrophil count 

Sepsis = SIRS + presumed/confirmed infection

Septic shock = Sepsis + sign of organ dysfunction

Question 7

What antibiotics should be used for treatment of intra-abdominal sepsis?

Answer 7

GAM
Gentamicin (coliforms)
Amoxicillin (enterococcus - lactic acid (from increased anaerobic resp)
Metronidazole (anaerobes)