Sepsis

Question 1

Define sepsis

Answer 1

Life-threatening organ dysfunction caused by an abnormal and uncontrolled host response to an infection

Question 2

Sepsis criteria

Answer 2

Presence of a known or suspected infection

Clinical features of organ dysfunction

Question 3

How is organ dysfunction quantified?

Answer 3

SOFA score > greater than or equal to 2 indicates sepsis.

Question 4

Explain SOFA score

Answer 4

Question 5

What allows for rapid assessment of potential sepsis?

Answer 5

qSOFA score based purely on clinical signs

Question 6

Explain qSOFA score

Answer 6

Known or suspected infection + qSOFA score 2 or more should be investigated and managed for sepsis

RR 22 or more/min (1p)

Altered mental state (1p)

SBP 100mmHg or less (1p)

Question 7

Sepsis 6

Answer 7

Question 8

OBS in sepsis

Answer 8

Sohuld be done at least hourly

Make sure nurses inform you if there is any deterioration

Question 9

Source identification of sepsis

Answer 9

Urine dip +/- culture

CXR

Swabs

CT or US

LP for CSF

Stool culture

Question 10

When should early senior support, involvement with ICU be considered?

Answer 10

Evidence of septic shock

Lactate >4.0 mmol

Failure to improve from initial management

Question 11

Common causes of pyrexia on surgical wards

Answer 11

7Cs

Chest infection

Cut wound infection

Catheter

Collection abdomen or pelvic

Calves DVT

Cannula Infection

Central line infection

Question 12

Definition of septic shock.

Answer 12

Sepsis with hypotension despite adequate fluid resus or requiring use of inotropic agents to maintain normal SBP