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CLASP sepsis > sepsis: defining a syndrome > Flashcards

sepsis: defining a syndrome Flashcards

1
Q

colonisation

A

presence of a microbe in the human body without an inflammatory response

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2
Q

infection

A

inflammation caused by the presence of a microbe in the human body

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3
Q

bacteraemia

A

the presence of viable bacteria in the blood

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4
Q

sepsis

A

life-threatening dysregulated host immune response to infection

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5
Q

you cannot have sepsis

A

unless you have an infection

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6
Q

tissue damaged by an infection produces

A

inflammatory mediators which cause the local features of infection and also produces cytokines, leukocytes also detect the pathogen and produce cytokines, the cytokines and inflammatory mediators travel into the blood stream causing the systemic features of infection

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7
Q

local features of infection

A

heat, pain, swelling, loss of function, redness

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8
Q

presence of cytokines in the blood affects

A
  • bone marrow
  • hepatocytes
  • hypothalamic
  • brain
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9
Q

the affect of cytokines

A

increases the energy demand on the body

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10
Q

cytokines affect on bone marrow

A

stimulates red bone marrow to increase white blood cell production called leukocytosis

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11
Q

why might WCC be low in sepsis

A

because the pathogen causing sepsis can release toxins which inhibit bone marrow

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12
Q

septic shock

A

is a subset of sepsis with circulatory and cellular/ metabolic dysfunction i.e. it is sepsis which does not respond to adequate IV fluid resuscitation

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13
Q

you cannot have septic shock until

A

fluid resuscitation ha been attempted and is unsuccessful

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14
Q

why is there a left shift in white cell count

A

because the bone marrow is trig to rapidly produce white cells so they are immature

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15
Q

systemic symptoms and signs

A
  • severe
  • chills/ riggers
  • nausea or vomiting
  • constipation or diarrhoea
  • malaise or anorexia
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16
Q

peritonitis

A

peritoneal cavity is normally sterile so leakage of the boewel content can cause peritonitis

17
Q

causes of peritonitis

A
  • perforated duodenal ulcer
  • perforated appendix
  • perforated diverticulum
  • perforated tumour
18
Q

SIRS

A

systemic inflammatory response syndrome is a non-specific clinical response which includes 2 or more of the following

  • temperature greater than 38 or less than 36
  • resp rate greater than 20 beats per minutes
  • heart rate greater than 90 beats per minutes
  • white blood cell count greater than 12,000 cells/mm cubed or less than 4000 cells/mm cubed
19
Q

sepsis is

A

SIRS AND a suspected or confirmed infection

20
Q

what else can SIRS be caused by

A
  • trauma
  • pancreatitis
  • burns
21
Q

septic shock is

A

sepsis with hypotension refractory to adequate fluid resuscitation i.e. sepsis plus one acute organ dysfunction: renal, respiratory, hepatic, haematological, CNS, unexplained metabolic acidosis, cardiovascular

22
Q

STOP

A

is this sepsis?? if yes implement sepsis 6 bundle within the hour

23
Q

sepsis 6 bundle

A

Blood culture (also other cultures i.e. urine, joint etc)
Urine outputt
Fluid resuscitation
Antibiotics IV stat
Lactate (also FBCS and biochem)
Oxygen (target saturations 94-98% except in COPD)

24
Q

SOFA score stands for

A

Sequential (sepsis related) organ function assessment

25
Q

SOFA is used predominantly

A

in ICU

26
Q

qSOFA is the

A

quick sofa and can be used elsewhere in the hospital

27
Q

qSOFA is used for

A

screening for outcome rather than screening for diagnosis

28
Q

qSOFA

A
  1. RR greater than 22
  2. Systolic blood pressure less than 100mmHg
  3. Altered GCS less than 14

1 point for each:
0= mortality less than 1%
1= mortality 2-3%
2 or more= mortality greater than 10%

29
Q

NEWS score

A

in a patient with a NEWS score of 5 or more and a known infection/ signs or symptoms of infection and at risk of infection think could this be sepsis and escalate care immediately

30
Q

physiological parameters included in NEWS score

A
  • resp rate
  • O2 sats
  • systolic blood pressure
  • pulse rate
  • level of consciousness
  • temperature

CLASP sepsis (17 decks)

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