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SCRIPT 4 > Sepsis in hospital > Flashcards

Sepsis in hospital Flashcards

1
Q

prompt recognition and the use of the x bundle can save lives and reduce the associated morbidity related to sepsis

A

sepsis six

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2
Q

a patient has red flag sepsis if they have an aggregate news2 score of x or above

A

7

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3
Q

a patient has red flag sepsis if they have an aggregate news2 score of 5 or 6 plus one of what following factors

A

lactate over 2
chemo in last 6 weeks
organ failure
patient looks unwell
patient actively deteriorating

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4
Q

all sepsis six care bundle actions should be done in x hrs of recognition of red flag symptoms

A

1

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5
Q

low clinical risk aggregate score

A

0-4

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6
Q

low - medium score

A

3 in any sector

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7
Q

medium clinical risk aggregate score

A

5-6

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8
Q

high clinical risk aggregate score

A

7 or more

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9
Q

sp02 scale 1 applies for most px, what is scale 2 reserved for

A

px w hypercapnic resp failure

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10
Q

true or false aki is evidence of organ failure

A

true

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11
Q

when should an antimicrobial prescription be reviewed and the patient switched to the oral route

A

when px is stable

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12
Q

why is it important to regularly monitor patients renal function when they have sepsis

A

can cause impairment and may improve with treatment causing need for dose adjustment

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13
Q

how can communication and management of sepsis patients be ensured

A

thorough documentation of treatment plans and effective handover

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14
Q

patients with what condition represent the largest group of patients with sepsis

A

pneumonia

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15
Q

which patient groups should news2 not be used in

A

children under 16 and pregnant women as physiological response to illness can be altered in these patients

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16
Q

amber flag sepsis is defined as an aggregate news2 score of 5-6 or 1-4 with what following parameters

A

lactate over 2
chemo in last 6 weeks
organ failure
patient looks unwell
active deterioration

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17
Q

the presence of amber flag sepsis should prompt you to send and review blood tests, what things would this include

A

fbc, ue, crp, clotting factors

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18
Q

who should you escalate amber flag sepsis to and within what time frame

A

senior clinicain within 1 hr

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19
Q

in the case of amber flag sepsis abx treatment if needed should be adminstered with a plan for source control and escalation within x hrs

A

3

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20
Q

what is the most severe form of sepsis

A

septic shock

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21
Q

in most cases giving x as part of the sepsis six care bundle will resolve septic hypotension

A

iv fluid replacement

22
Q

septic shock is sepsis and

A

refractory hypotension

23
Q

when looking for sepsis what drug class can mask tachycardia associated with an inflammatory response

A

bb

24
Q

what drug could be used to reduce a fever that is masking fever

A

paracetamol

25
Q

what is cryptic shock

A

lactate over 2 in presence of normal blood pressure

26
Q

in a patient with sepsis myocardial depression may occur which will cause initiation of acute coronary syndrome treatment. In patients that survive cardiac function will usually recover within what time period

A

7-10 days

27
Q

most common cause of puerperal sepsis

A

bacterial endometritis

28
Q

what common sites does puerperal sepsis affect

A

genital tract and uterus

29
Q

list some common pathogens that cause sepsis in pregnancy

A

strep pyrogens
e coli
staph aureus
strep pneumoniae
mrsa
esbl

30
Q

what is included in the sepsis six

A

ensure senior clinician attends
admin o2 if needed
obtain iv access and take bloods
give iv abx and think source control
give iv fluids
monitor

31
Q

at least 2 sets of blood cultures should be taken in what 2 bottles

A

aerobic and anaerobic

32
Q

should you wait for blood cultures before giving abx

A

no

33
Q

why should culture bottles not be overfilled

A

can -> false positive results

34
Q

4 important considerations

A

allergy
recent travel
recent hospital admission
resistance and sensitivities

35
Q

all patients should recieve a full first dose/ loading dose of abx within x hr of diagnosis

A

1

36
Q

if the source of sepsis could be amenable to drainage aim to achieve this asap but definitely within x hrs

A

12

37
Q

in those aged 16 years and above what fluid should be given and over what period

A

500ml bolus over less than 15 mins

38
Q

what type of iv fluid should be given

A

crystalloid that contains sodium in range of 130-154 like hartmans or sodium chloride 0.9%

39
Q

at what time period should patients be reviewed and have their management plan documented including the next review or stop date

A

48-72hrs

40
Q

give 2 places where you should document that abx is for the treatment of sepsis

A

prescription and medical notes

41
Q

all patients should receive first dose of abx regardless of renal function true or false

A

true

42
Q

what band should patients wear to identify allergy status

A

red

43
Q

you should ask about recent travel within x months

A

12

44
Q

the sepsis 6 toolkit provides management for the x hr of diagnosis

A

first

45
Q

all sepsis patients should be reviewed after an hour to ensure

A

treatment is working and source under control

46
Q

fluid resus regimen for adult patient with Red Flag sepsis as part of the Sepsis Six® Care bundle?

A

500 ml of Hartmann’s or sodium chloride 0.9% over less than 15 minutes.

47
Q

which NEWS2 score indicates Red Flag sepsis and initiation of Sepsis Six Care bundle?

A

aggregate 7 or above, or

aggregate 5 or 6, plus any ONE of the following:
- Lactate > 2 mmol/litre
- Chemo in last 6 weeks
- Other organ failure evident (e.g. AKI)
- px looks extremely unwell
- px actively deteriorating

48
Q

for amber flag sepsis in adults, what should be done

A

full set of bloods should be sent

49
Q

How quickly should the actions of the Sepsis Six® care bundle be completed following recognition of Red Flag sepsis?

A

60

50
Q

Cryptic shock is where patients are found to have a high X concentration in the presence of a Yblood pressure

A

lactate, normal

these patients may have sepsis and require urgent treatment.

51
Q

news score can be used to assess what

A

clinical deterioration over a period of time

52
Q
A

SCRIPT 4 (5 decks)

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