Sepsis, Immunocompromised Flashcards
SIRS Criteria (Old criteria but might still be used by some doctors)
3 Teas and white sugar
Temperature >38 or <35 Tachycardia >100 Tachypnoea >20 WBC <4 or >12 Glucose >7
Sepsis = 2 of the above + source of infection
QSOFA criteria (HAT criteria)
- Hypotension: systolic <100mmHg
- Altered mental state: GCS <15
- Tachypnoea: respi rate >22
Name Sepsis 6
- Give oxygen
- Take lactate (ABG)
- Give IV fluids
- Take urine output
- Give a/b
- Take blood cultures
What is a normal neutrophil range
2.5-7.5 x10^9/L
Which neutropenic patients may require antibiotic prophylaxis
Neutropenia expected to last >7 days
What type of antibiotic is given as antibiotic prophylaxis ot neutropenic patients
Fluoroquinolones
eg levofloxacin
Factors that affect how much IV fluid to give a patient in a fluid challenge
- weight
- if they have heart failure
Should crystalloids or colloids be given to patients in a fluid challenge
Crystalloids
eg 0.9% saline, Hartmann’s
Colloids have risk of anaphylactic shock
What NEWS score requires a fluid assessment
5 or more
note that CO2 retention can cause confusion, so not always septic
What areas get swabbed for MRSA
- Nose
- Groin
- Wounds, broken skin
- Stoma sites, invasive device entry sites
- CSU if catheterised
- Sputum if coughing/ has tracheotomy
- Umbilicus (infants only)
How to definitely say that someone has had MRSA successfully eradicated
3 negative screening sets of swabs, at least 1 week apart
start rescreen 48h after complication of eradication therapy
Definition of sepsis
Dysregulated inflammatory response leading to organ dysfunction
Definition of septic shock
Dysregulated inflammatory response +
Persisting hypotension (despite 3L IV fluid) OR
lactate >2
Signs of organ dysfunction in sepsis
- Lactate >2
- New AKI
