Sepsis and Septic shock Flashcards
what criteria is involved in the qSOFA?
hypotension: systolic BP < 100mHg
altered mental status
tachypnoea > 22/min
what are the clinical signs of sepsis?
fever >38 hypothermia < 36 tachycardia >90 tachypnoea > 20 altered mental status hyperglycaemia . 8mmol/l
what are the features of inflammation in sepsis?
leukocytosis or leucopenia
high CRP
high procalcitonin
what are the haemodynamic features of sepsis?
arterial hypotension with systolic < 90mmHg
MAP < 70mmHg
02 sats < 70%
what features suggest impaired tissue perfusion due to sepsis?
decreased capillary refill time
high lactate
skin mottling
what investigations should be carried out to investigate sepsis?
take 3, give 3;
blood cultures
blood lactate
measure urine output
what is given for the management of sepsis?
take 3, give 3;
IV saline
IV antibiotics
O2
what is the difference between sepsis and septic shock?
SIRS + infection
severe sepsis + hypotension
(severe sepsis is sepsis + end organ damage)
What is the motality percentage if someone with shock as a qSOFA score > 2?
10%
What bacterial factors affect the presentation of sepsis?
Gram positive vs negative
Virulence factors
Bioburden
what is systemic inflammatory response system?
a systemic response to various insults such as trauma, infection etc. \+ 2 of the following; - tachycardia > 90bpm - tachypnoea > 22 bpm or PaC02 < 4.3 kPa - hyperglycaemia > 8.3 mM - temp > 38.3 or < 36 - acutely altered mental state - WCC > 12
what are the 3 main risk factors for sepsis?
immunocompromised
indwelling devices
recurrent antibiotic therapy
what medication should be given to control fever in sepsis?
paracetamol 1g
+/- ibuprofen 400mg if not contraindicated
what are the possible complications of sepsis?
hepatic failure respiratory failure renal failure cardiac failure disseminated intravascular coagulation shock death
