septicemia Flashcards
1
Q
TERMS
A
- SEPTICEMIA- presence of pathogens and toxins in blood
- BACTEREMIA- presence of bacteria and toxins in the blood
- SEPSIS- whole body inflammation caused by infection
2
Q
SIRS
A
- systemic inflammatory response syndrome (SIRS)
- a systemic inflammatory response
- typically an immune response to infection but not always
3
Q
SIRS CRITERIA (ANY TWO OR MORE)
A
- TEMP ( >100.4 OR <95.0) (>38 OR <36)
- RR (>20 OR PaCO2 < 32)
- HR (>90/MIN)
- WBC ( >12,000 OR <4,000)
4
Q
SIRS STAGES
A
- SEPSIS
- SIRS with a microbial source - SEVERE SEPSIS
- sepsis with >one organ system dysfunction (hypotension, AMS, Acidosis, oliguria, ARDS) - SEPTIC SHOCK
- severe sepsis with hypotension unresponsive to fluid resuscitation - MODS
- > one organ system requiring interventional homeostasis
5
Q
MEWS AND PEWS
A
- modified early warning system
- pediatric early warning signs
- like SIRS criteria but may include more/fewer signs
6
Q
WHAT IS SEPSIS
A
- sepsis is the result of an infection
- the infection is uncontrolled or spreads and releases bacteria or toxins into the blood
- this triggers the systemic inflammatory response
- sepsis is SIRS caused by an infection
7
Q
SEPSIS PROCESS
A
-when the inflammatory response becomes exaggerated, inflammation and coagulation increase
- leads to microthrombi, and obstruction of capillaries
(tissue isn’t perfusing ) - endothelial (vein/arterial) damage, vasodilation, increased capillary permeability
8
Q
SEVERE SEPSIS
A
- if sepsis is not controlled it enters what we call severe sepsis
- this is sepsis with one organ system damaged or experiencing failure
- BP decreases , poor organ perfusion
9
Q
DISSEMINATED INTRAVASCUALR COAGULATION
A
DIC- widespread activation of clotting which causes clots in small blood vessels
- leads to a drop in tissue perfusion which can lead to tissue and organ damage or failure
- sepsis in one of the causes
10
Q
TREATMENT OF DIC
A
- monitor vital signs, clotting factors
- assess for signs of hemorrhage, bleeding
- fix hypovolemia (give fluid)
- possibly platelet transfusion
- possibly heparin, especially prophylactically when DIC is slowly evolving, not when it is quick
11
Q
WHAT IS SHOCK
A
- generally , it is when there is sufficient blood flow to meet the body’s demands (lack of perfusion )
- several types
1. cardiogenic
2. hypovolemic
3. anaphylactic
4. neurogenic
5. septic
12
Q
SEPTIC SHOCK
A
this is severe sepsis with persistent hypotension which is unresponsive to fluid replacement therapy and organ system damage and /or failure to 2 or more organ systems . (MODS) multiple organ dysfunction syndrome
- very high mortality rate
- organ systems become damaged as a result of decreased tissue perfusion
- hypotension
- microvascular occlusion (DIC)
13
Q
STAGE 1: COMPENSATORY SHOCK
A
- baroreceptors detect drop in MAP
- SNS kicks in, ups HR, and cardiac contraction
- peripheral vasoconstriction
- perfusion of systems is maintained due to this
- signs are nearly imperceptible
14
Q
STAGE 2: PROGRESSIVE SHOCK
A
- sustained drop in BP
- compensatory mechanisms from stage 1 are still active , but unable to keep MAP up
- vasoconstriction actually starts to limit blood flow
- lactic acid builds up causing acidosis
- Sodium- potassium pump of cels fails, leads to loss of intracellular K, Na and water move in
- cells swell up from Na and water, causes organelle damage
15
Q
STAGE 3: REFRACTORY SHOCK
A
- tissue damage and lack of oxygen become so widespread that tissues and organ s fail and die
- even if MAP is restored, damage has become too widespread to prevent organ death
