Sepsis And Shock Flashcards
WHat is sepsis? Criteria to diagnose sepsis?
Sepsis is life threatening organ dysfunction results from body’s response to infection.
Using qSOFA or SOFA.
SIRS 2 out 4 criteria plus infection = 10% mortality
MODS = >70% mortality
What is septic shock?
Sepsis + requiring inotropes (fluid resistant hypotension) OR
Lactate > 4 mmol/L
Ref : Surviving Sepsis Campaign, 2004
5 component of sepsis surviving bundle?
- Antibiotics
2.
3.
4. - Low treshold to initiate inotropic support
In SOFA score, what systems are involved?
What is ARDS?
How to calculate PFR and what is the normal value?
Level of Care in ICU, HDU or CCU.
ICU - need 2 organ supports (not lung)
What are components of qSOFA?
> 2 = high mortality rate requires ICU
Use mainly for triaging septic patients
Cold ischaemia versus warm ischaemia?
Cold ischaemia
Warm ischameia- circulation from the heart
What is ischaemia?
What are biomarkers for sepsis?
Leucocyte count
C reactive protein - acute phase reactant
ESR
PCT - produces by macrophages and hepatocytes in response to inflammation, helps early detection, helps guiding in deescalating antibiotics
Beta glucan/Cytokine - under studies
Principle of management of sepsis. MRCS style
What is antimicrobial?
How would you initiate fluid therapy?
Indicated if hypotensive
Lactate >4
30cc/kg to 60cc/kg using Hartmann or any crystalloids
Example of crystalloids?
Name the 4 phases of fluid therapy - ROSDe
Rescue phase
Optimization
Stabilization
Deescalation
