Sepsis DEFINITIONS

Question 1

How would you define neutropenic fever?

Answer 1

Neutrophils: <0.5 OR <1.0 if recent chemotherapy
Fever/hypothermia: <36 or 38+
SIRS
Sepsis
Septic shock

Question 2

How do you measure the NEWS score? (6)

Answer 2

Respiratory rate
O2 sats
Systolic BP
Heart rate
AVPU (alert, voice, pain, unresponsive)
Temperature

Question 3

How would you define sepsis? (2)

Answer 3

Systemic inflammatory response (SIRS): 2+ of:

• Heart rate: 90+
• Temperature: <36 or 38+
• Respiratory rate: 20+
• WCC: <4 or 12+

Organ dysfunction: 1+ of:

• Confusion
• Hypotension: <100/60
• Respiratory rate: 22+

Question 4

How would you define SIRS? (4)

Answer 4

Heart rate: 90+
Temperature: <36 or 38+
Respiratory rate: 20+
WCC: <4 or 12+

Question 5

What are the “sepsis 6”?

Answer 5

High flow oxygen
IV fluid replacement
Blood cultures
IV antibiotics
Bloods (lactate and FBC)
Monitor urine output (consider catheter)

Question 6

What is the clinical application of the NEWS score? (4)

Answer 6

0-2 points:
-Nurse review

3 points:
-SHO review within 1 hour

4-6 points:

• SHO review within 30 minutes
• Screen for sepsis
• Consider continuous monitoring

7+ points:

• Registrar review immediately
• Continuous monitoring
• Move patient to higher level care

Question 7

How would you define sepsis for a longer exam question? (3)

Answer 7

The presence of likely or confirmed infection PLUS organ dysfunction.

Measured by the qSOFA score, which gives 1 point for each of:

• Hypotension: <90/60
• Respiratory rate: 22+
• Confusion

A score of 2+ suggests sepsis.

Question 8

How would you treat sepsis?

Answer 8

NEWS assessment

Sepsis 6

Question 9

How would you treat neutropenic fever?

Answer 9

NEWS assessment (within 15 minutes)
Sepsis 6
If oncology patient, discuss with oncologists

Question 10

Define septic shock.

Answer 10

Sepsis, PLUS
Hypotension that persists despite IV fluids, PLUS
Lactic acidosis