Sepsis Flashcards
What pathway is used in suspected sepsis?
Sepsis 6
What mnemonic can be used to remember the sepsis six?
BUFALO
What phrase can be used to remember the Sepsis 6?
‘Give three, take three’
What 3 things do you ‘give’ in suspected sepsis?
IV fluids
IV antibiotics
High flow oxygen
How should oxygen be administered in suspected sepsis?
15l/min through non-re-breathe mask
How should IV fluid challenge be administered in suspected sepsis?
500ml bolus over 15mins (or faster)
What is a good antibiotic to use in suspected sepsis?
Meropenem
What class of abx is meropenem?
Carbapenem
What is the mechanism of action of meropenem?
Inhibits cell wall synthesis
What 3 things do you ‘take’ in suspected sepsis?
Blood cultures
Measure urine output
Measure serum lactate
When should the sepsis screening tool be used?
If NEWS ≥3 or the patient looks acutely unwell
Why are loads of patients NEWSing ≥3 and no one cares?
Because the cause has to be likely due to an infection - lots of patients are NEWSing 3 for other reasons
If a patient NEWS ≥3 and likely infection what should be looked for?
Red Flag symptoms
What are Red Flag symptoms?
Responds only to voice/pain/unresponsive SBP ≤90 HR > 130 RR ≥25 Needs O2 to keep sats >92% Non-blanching rash Anuric for 18 hours Lactate >2 Recent chemo
If a Red Flag is present what should happen?
Start Sepsis 6 Now!
If no Red Flags?
Check for Amber Flags
What are the Amber Flags of Sepsis?
Concerns about mental status Acute deterioration in function Immunosuppressed Trauma/ surgery/ procedure in last 6 weeks RR 21-24 SBP 91-100 HR 91-130 OR new dysrhythmia Anuric for 12-18 hours Temp < 36ºC Clinical signs of wound, device or skin infection
What should be done if 2 Amber Flags found (and consider if 1)?
Send bloods including U&E’s
Contact ST3 or higher
If patient is an Amber Flag patient and has AKI what should be done?
Start Sepsis 6 Now!
Is every Sepsis 6 treated patient septic?
No probably not but better be safe than sorry
What should be done whilst treating for sepsis?
Undertake appropriate investigations for suspected infection and attempt to identify organism
If an organism is identified what change should be made to management?
Switch eventually to a narrower spectrum antibiotic that organism has sensitivity to
