Sepsis

Question 1

Define sepsis

Answer 1

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

Question 2

What is qSOFA criteria?

Answer 2

Altered mental status
RR > 20
SBP < 100

2 or more should be treated as sepsis

Question 3

What is septic shock?

Answer 3

Sepsis with either

• lactate > 2 despite fluid resus
• needing vasopressors to maintain MAP > 65mmHg

Question 4

What are Sx of sepsis

Answer 4

Fever, tachycardia, tachypnoea, hypotension, confusion, low O2 sats, oliguria, cyanosis

Symptoms related to the source

Question 5

What are risk factors for sepsis

Answer 5

Age, immunocompromised, indwelling lines, recent surgery, diabetes, PWID, pregnancy, breaches in skin integrity

Question 6

What is sepsis 6?

Answer 6

6 things you need to do in first hour

1. take blood cultures
2. catheterise and take urine output
3. take lactate
4. give fluids: 500ml challenge
5. give o2
6. give Abx

Question 7

What other important Ix in sepsis?

Answer 7

Ongoing NEWS
Routine bloods and gad
ECG

Related to source e.g. sputum cultures, CXR, stool, CSF….

CT can help to identify hidden collections that can be the source e.g. if acute abdomen

Question 8

What are differentials?

Answer 8

Non-infectious causes of SIRS e.g. MI, pericarditis, pancreatitis, PE… will depend on presentation

Question 9

What is Rx of sepsis?

Answer 9

Once sepsis 6 done

Speak to ICU

Manage shock, ARDS, DIC.

Monitor

Question 10

What defines failure to respond to treatment?

Answer 10

SBP remaining < 90

Persistent reduced consciousness

RR > 25, needing mechanical ventilation

lactate not reduced by > 20%

Question 11

What treatments will critical care give

Answer 11

Inotropes, vasopressors, corticosteroids

Ventilation

Organ support