sepsis + shock Flashcards
diagnosis SIRS
2 or more of: temp >38.5; HR>90; RR>20 or PaCO2>4.3; WBC >12 or
diagnosis sepsis
evidence infection with 2 or more SIRS features
diagnosis severe sepsis
sepsis alongside 1 or more signs of organ dysfunction: hypotension bp
diagnosis septic shock
severe sepsis and acute circulatory failure despite adequate volume resus
signs septic shock
bp 60, fall in syst BP >40, lactate >4
sepsis 6
O2, fluids, antibios, lactace, urine output, cultures
what % O2 and in COPD/type 2 failure
100% but in those with COPD/type 2 failure- start at 24% and titrate up
broad spec abs - neutropenia
piperacillin/tazobactam- tazocin
broad spec- resp
doxy, amox
broad spec- GI
co amoxiclav
broad spec cardio
benzlypenicillin
broad spec CNS
ceftriaxone
what do you risk when giving fluids
pulmonary and peripheral oedema
what is lactate due to
hypoperfusion, hypoxia
definition shock
acute circulatory failure with inadequate tissue perfusion results in hypoxia
types of shock
hypovolaemic, cardiogenic, obstructive, distributive
what is hypovolaemic due to
haemorrhage, burns
features hypovolaemic
skin cold, pale, slow cap refill, anuria/oliguria, drowsy, confused, tachy, narrowed pulse pressure, sweating
features cardiogenic
myocardial failure- incr JVP, pulsus alternans, gallop, basal crackles
what can obstructive shock be due to
obstructed outflow- PE, restricted cardiac filling
features obstructive shock
incr JVP, pulsus parodoxus, signs PE
what is distributive shock
sepsis, anaphylaxis
features sepsis, severe and septic shock
pyrexia and rigors, N&V, bounding pulse, hypotension, rapid cap refill
