Sepsis resuscitation

Question 1

What is the sepsis 6 bundle

Answer 1

Oxygen 
Blood cultures 
IV antibiotics 
IV fluids
lactate levels 
measure urine output

Question 2

What is meant by give 3 take 3

Answer 2

Give 3:
Oxygen
IV fluids
IV antibiotics

Take 3:
Blood cultures
Lactate
Urine output

Question 3

Oxygen

Answer 3

94-98% targets
ABG is suspicious
Be careful in COPD and lactic acidosis

Question 4

Blood cultures

Answer 4

Take all cultures: blood, sputum, urine
Call surgeons for abscess
SSTI
Find infection source

Question 5

IV antibiotics

Answer 5

check guidelines

administer in 1st hour

Question 6

IV fluids

Answer 6

Fluid challenge
give 250-500ml fluids over 15 min
crystalloid: saline or Hartmanns
aim for 30ml/kg over 3 hours

Question 7

Aim for MAP

Answer 7

> 65 mmHg

Question 8

What happens when fluid resuscitation is unsuccessful

Answer 8

septic shock

taken to MHDU for vasopressors e.g. noradrenaline

Question 9

Lactate

Answer 9

if lactate is high, there is hypoperfusion

Question 10

measure urine output

Answer 10

marker of organ perfusion
catheter insertion
aim >0.5ml/kg/hr

Question 11

What are concerning features/symptoms

Answer 11

new confusion
high RR
low BP
low blood sugar

Question 12

What should be done in hours 2-6

Answer 12

REASSESS

ABCDE