Sepsis Flashcards
Bacteraemia
Presence of live bacteria in the the blood stream (can be in healthy individual with no sx)
Septicaemia
Presence of pathogen in blood stream leading to sepsis
Sepsis
Life threatening organ dysfunction caused by a dysregulated host response to infection = identified by a change of 2 or more in patients SOFA score
Old sepsis definition - SIRS
2 or more of:
- Temp <36 or >38
- HR >90
- RR >20 or PaCO2 <4.3
- WCC >12 or <4
Old sepsis definition = 2 or more of the above signs resulting from infection
New septic shock definition
Vasopressor requirement to maintain a MAP of 65 in absence of hypovolaemia
quick sofa - qSOFA
Recommended at the bedside
- Altered mental state
- BP <100
- RR >22
Score of 2 or higher suggestive of sepsis + should prompt calculation of SOFA score
SOFA score
Used in an ITU setting
- Requires bloods + gas
Respiration - PaO2/FiO2 Coagulation - platelets Liver - bilirubin CV - catecholamine doses CNS - GCS Renal - creatinine Urine output
Score calculated from these categories.
Common causes of sepsis
Resp –> urinary –> acute abdo/upper GI –> skin/soft tissue –> post op
Red flag sepsis
Set of criteria to measure rapidly which suggests it is highly likely a patient has a degree of organ dysfunction = derived from NEWS score
Neutropenic sepsis
Temp >38 or any signs/sx of sepsis in a person with neutrophil count <0.5
Sepsis 6
Give
- O2 to maintain sats 94%
- IV abs
- Fluid challenge
Take
- Blood cultures
- Lactate
- Measure urine output
Most common complication of sepsis
AF
Complications of sepsis
AF DIC End organ dysfunction - renal failure Adrenal failure - classically neiserria meningis destroys adrenal glands Tissue deaths ARDS
Post sepsis syndrome
Physical - TATT, hair loss, dry skin, vision changes, sensation changes, SOB, myalgia
Psychological
