Severe infection & sepsis Flashcards
Define infection
Invasion & multiplication of pathogenic microbes
Define SIRS
systemic inflammatory response syndrome >1 of: - temperature 38°C - heart rate >90/min - respiratory rate >20/min or pCO2 12x109/dl or >10% immature WBCs
Define sepsis
systemic inflammatory response to infection (SIRS + known or suspected infection)
Define severe sepsis
sepsis + organ dysfunction (including septic shock)
Define septic shock
sepsis + hypotension (SBP
What is the sepsis 6?
Within 1 hour of suspecting severe sepsis → Sepsis Six Care Bundle:
- Give high-flow oxygen
- Take blood cultures – identify what’s in the blood to get right ABX
- Give empirical IV antibiotics – don’t know what best ABX is
- Measure FBC & serum lactate (what’s going on in tissues)
- Start IV fluid resuscitation
- Start accurate urine output measurements
Which viruses & bacteria can cause bronchitis?
- Viruses - rhinovirus (cold), influenza
- Bacteria - strep, haemophilus influenzae
What are the signs & symptoms of bronchitis?
Symptoms - dyspnoea, cough, sputum (usually), wheeze
Signs - fever (usually), tachypnoea, crackles, wheeze
What is the pathology of bronchitis?
Infection & inflammation of airways
What is the pathology of pneuomonia?
infection & inflammation of alveoli
What viruses & bacteria can cause pneumonia?
Viruses - influenza
Bacteria - strep, staph
What are the signs & symptoms of pneumonia?
Symptoms - dyspnoea, cough (usually), sputum (usually), pleurisy
Signs - fever, tachypnoea, crackles, ↓ or bronchial breath sounds (more loudly due to consolidation within area of lung)
Is sepsis common in bronchitis or pneumonia?
Pneumonia
What investigations would be done for lower respiratory tract infections?
- PEFR – airway constriction
- Full blood count – increased leukocytes
- U+Es
- CRP – increased in bacterial infection
- Lactate – in severe sepsis – tissues not working properly
- ABGs – hypoxia +/- hypercapnia
- CXR – shadowing consistent with pneumonia. (not good at seeing bronchitis)
- Nose & throat swabs – for viral investigations
- Sputum – for bacterial investigations
When would you admit someone to hospital with a LRTI?
CURB-65 --> - Confusion - Urea >7mmol/L – kidney injury - Respiratory rate >30/minute – normal is 12-16/min - Blood pressure 1 → admit • If score >2 → IV treatment