Septicaemia

Question 1

facts about sepsis

Answer 1

Every year there are around 250,000 cases of sepsis in the UK according to the UK Sepsis Trust .
Scarily at least 46,000 people die every year as a result of the condition.
That is more than the deaths due to breast cancer, bowel cancer and prostate cancer combined
Every hour that severe sepsis goes untreated raises the risk of death by 8%.

Question 2

One in five of those that survive are left with long term damage to organs such as:

Answer 2

Kidneys
Lungs
Liver

Question 3

Sepsis can arise from something as simple as a minor infection. True/false

Answer 3

True. Sepsis can arise from something as simple as a minor infection.

Question 4

Meaning of sepsis

Answer 4

sepsis/septicaemia is an infection of the blood and requires prompt treatment

Question 5

Sepsis is usually a result of a __________________

Answer 5

Sepsis is usually a result of a primary infection in another part of the body, that may have been left untreated (often patients do not want to bother healthcare professionals) or has been inadequately treated (perhaps the organism is resistant to the antibiotic the patient has been prescribed).

Question 6

Primary infections can be associated with sepsis?

Answer 6

Urinary tract infections
Pneumonia, respiratory tract infections
Gastrointestinal infections

Question 7

However sepsis can also be a complication of:

Answer 7

Surgery
Minor procedures
Catheterisation
Mechanical ventilation

Question 8

Both_______ and ________organisms can cause sepsis,

Answer 8

Both Gram positive and Gram negative organisms can cause sepsis,

Question 9

Gram positive organisms such as _______, ____________, ___________ and __________ are all associated with sepsis.

Answer 9

Gram positive organisms such as Staph aureus, Streptococcus pneumoniae, Streptococcus pyogenes and Enterococcus are all associated with sepsis.

Question 10

The medical terms to be aware of in these situations are:

Answer 10

Bacteraemia
Sepsis
Severe sepsis
Septic shock

Question 11

When considering septicaemia it is important to recognise that this is more than just an infection. Although the bacteria will cause the initial stimulation of the immune system. This system will then go into overdrive and will result in the increased release of pro-inflammatory cytokines such as:

Answer 11

Tumour necrosis factor.
Interleukin 1 (IL-1)
Interleukin 6 (IL-6)

Question 12

List the bacteria causes of sepsis

Answer 12

Gram positive and Gram negative organisms can cause sepsis,

Question 13

what are the main symptoms of sepsis?

Answer 13

rash (anywhere on the body)

fever/vomiting

cold hands and feet/ shivering

rapid breathing

stomach/joint/muscle pain

drowsy and less responsive

convulsion or fit

Question 14

List examples of gram-positive bacteria associated with sepsis

Answer 14

Staph aureus, Streptococcus pneumoniae, Streptococcus pyogenes and Enterococcus are all associated with sepsis

Question 15

The trigger of the immune system required in sepsis is caused by the bacterial cell wall component known as…

Answer 15

Lipoteichoic acid (LTA).

Question 16

List examples of Gram-negative organisms associated with sepsis.

Answer 16

E.coli, pseudomonas aeruginosa and Salmonella spp are associated with sepsis.

Question 17

The release of the cytokines and secondary mediators will result in __________-(causing a drop in the patients blood pressure), _________– (causing shortness of breath), ___________–(resulting in the pooling of fluids in the extremities), __________-(disseminated intravascular coagulation) and the stimulation of more _______and secondary mediators allowing the cycle to continue.

Answer 17

The release of the cytokines and secondary mediators will result in vasodilation (causing a drop in the patients blood pressure), bronchoconstriction (causing shortness of breath), increased vascular permeability (resulting in the pooling of fluids in the extremities), blood clot formation (disseminated intravascular coagulation) and the stimulation of more cytokines and secondary mediators allowing the cycle to continue.

Question 18

The trigger of the immune system required in sepsis caused by the gram-negative bacterial cell wall component is known as …..

Answer 18

Lipopolysaccharide (LPS).

Question 19

The initial symptoms associated with sepsis very much resemble______, however as time progresses these symptoms will advance to resemble ___________. It is very important to recognise the red flags associated with sepsis (coming up in the next pages), as prompt treatment is essential to reduce the morbidity and mortality associated with this condition.

Answer 19

The initial symptoms associated with sepsis very much resemble flu, however as time progresses these symptoms will advance to resemble a more advanced infection. It is very important to recognise the red flags associated with sepsis (coming up in the next pages), as prompt treatment is essential to reduce the morbidity and mortality associated with this condition.

Question 20

Patients can also suffer from fungal septicaemia and this is mostly associated with candida species. T/F

Question 21

what are the main symptoms of sepsis?

Answer 21

rash (anywhere on the body)

fever/vomiting

cold hands and feet/ shivering

rapid breathing

stomach/joint/muscle pain

drowsy and less responsive

Question 22

List the CNS complication during sepsis

Answer 22

confusion
Delirium
altered consciousness
cognitive loss

Question 23

list the cardiovascular complication during sepsis

Answer 23

Ischemia

Dilatative failure

Question 24

List the pancreas complication during sepsis

Answer 24

Ischemia
Decreased insulin production
Hyperglycemia

Question 25

List the kidney complication during sepsis

Answer 25

Edema

Acute Tubular injury

Question 26

List the adrenals complication during sepsis

Answer 26

Hemorrhage

Lipid depletion

Question 27

what are the red flags in sepsis

Answer 27

Responds only to voice or pain / unresponsive
Acute confusional state
Systolic B.P ≤ 90 mmHg (or drop > 40 from normal)
Heart rate > 130 per minute
Respiratory rate ≥ 25 per minute
Needs oxygen to keep SpO2 ≥ 92%
Non-blanching rash, mottled / ashen / cyanotic
Not passed urine in last 18 h / UO <0.5 ml / kg / hr
Lactate ≥ 2 mmol / l
Recent chemotherapy, as this will predispose the patient to a primary infection.

Question 28

what are the lungs sepsis complication

Answer 28

oedema

diffuse alveolar damage

acute lung injury

ards

Question 29

what are the liver sepsis complication

Answer 29

steatosis

cholestasis

centriacinar necrosis

Question 30

microbiology result

Answer 30

108/L Escherichia coli
Urine Sensitivity: Resistant: Amoxicillin, cefpodoxime, trimethoprim, cefuroxime, gentamicin
Sensitive: Nitrofurantoin, norfloxacin, ceftazidime, meropenem, piperacillin/tazobactam, fosfomycin, mecillinam, temocillin

Question 31

treatment for patient

Answer 31

Your answer :
Meropenem

Response:
Yes, this is a treatment option and would be considered if the patient is suffering from a multi-resistant infection.

Piperacillin/tazobactam

Response:
Yes, this is also a treatment option and would normally be considered if the patient is suffering from a Pseudomonas infection.

Question 32

sepsis

Answer 32

Don’t forget if you patient is well enough they can be discharged from hospital with oral antibiotics. So it is important to consider the discharge medication that you would prescribe. In this case the patient was discharged on oral norfloxacin 400mg bd for 10 days