Sepsis

Question 1

Define Sepsis

Answer 1

Life-threatening organ dysfunction caused by a dysregulated host response to infection

Question 2

Define septic shock

Answer 2

Sepsis +:

• Lactate >2mmol/L despite adequate fluid resus OR
• Patient req. vasopressors to maintain mean arterial pressure >65mmol/L

Question 3

Which patients should you have a low threshold for assessing sepsis in?

Answer 3

Patients with communication difficulties

Immunosuppressed, on chemo or IVDU

Recent surgery

Pregnant or recent birth

Indwelling lines/foreign material

Question 4

What may place someone at moderate to high risk category for sepsis?

Answer 4

Reports of altered mental state
Resp rate 21-24
Systolic BP - 91-100
HR- 91-130 or new arrhythmia
Urine output - nil for 12/18hr or 0.5-1ml/kg/hr if catheter
Local signs of infection
Rigors or temp <36
Impaired immunity - illness/drugs
Recent surgery/trauma/invasive procedure

Question 5

What may place a patient in the high risk category for sepsis

Answer 5

Objective evidence of altered mental state
Resp rate >24
FiO2 >40% to maintain sats >92%
Systolic BP <90 or drop of >40 from baseline
HR >130
Urine output - nil for 18h or <0.5ml/kg/hr if catheter
Mottled, ashen or cyanotic skin or non blanching rash

Question 6

What is the acute management of sepsis?

Answer 6

Sepsis 6:

• Give Abx
• Give O2
• Give Fluids
• Take serum lactate
• Take blood culture
• Take Urine output

Inform seniors and lease with relevant teams (surgery if post op patient etc.)