Sepsis in adults

Question 1

What is sepsis?

Answer 1

Refers to a systemic inflammatory response to infection that can lead to multi-organ compromise and is a medical emergency.

Has significant morbidity and mortality rates.

At least two of the following symptoms:
- temp >38 or <36
- HR >90
- RR >20
- WBC >12000 /mm³ or <4000/mm³

Question 2

What is severe sepsis?

Answer 2

Sepsis + Evidence of organ dysfunction (e.g. confusion, hypoxia, oliguria, or metabolic acidosis)

Question 3

What is septic shock?

Answer 3

Refers to severe sepsis + hypotension (despite adequate fluid resuscitation) or lactic acidosis (lactate >4mmol/L).

Question 4

Presentation of sepsis?

Answer 4

Fever, sweats or chills
SOB
Headache
Nausea and vomiting
Diarrhoea

Tachycardia
Hypotension
Pyrexia
Peripheral vasodilation
Hypoxia
Tachypnoea
Hypothermia

Question 5

IVx/management of sepsis?

Answer 5

Six key steps in the IVx (Sepsis six)

1. Bloods (FBC, U&Es, LFT, CRP, lactate)
2. Blood culture
3. Oxygen (if required)
4. IV abx
5. IV fluid resuscitation
6. Monitor urine output

Other:
Imaging (CXR, echocardiogram, abdominal US)
Viral PCR (for influenza)
Urinalysis +/-culture
Lumbar puncture