SIRS Sepsis Septic Shock and MODS Flashcards
Systemic Inflammatory Response Syndrome (SIRS)
Inflammatory response to clinical insults
Ex. Infection, ischemia, trauma, surgery, or malignancy
Needs two of the following to be diagnosed
Fever 100.4 or less than 96.8 F
HR > 90 bpm
RR > 20 breaths/min
PaCO2 < 32 mmHg
WBS < 4000 or 1200 or bands
Shock
Deficit in tissue perfusion
Hypovolemic Shock
fluid loss
Cardiogenic Shock
Cardiac Condition
Obstructive
Impeeding Blood Flow
Distributive Shock
Septic - infection
Anaphylactic - allergies
Neurogenic - neuro
Initial Shock Stage
Hypoperfusion / decrease CO
less oxygen to tissues
release of lactic acid
NO s/s
Compensatory Shock Stage Neural / Endocrine/ Chemical responses
Clinical S/S but can be reversed
Neural responses -
baroreceptors detect drop in BP
release of epi/norepi
Dilation of coronary arteries
Systemic vasoconstriction
Goes from glycogen to glucose for enegery
Endocrine responses -
decrease in BP
elevated glucose
RAAS system - conserves NA and water
Chemical -
V/Q mismatch
Compensatory Shock S/S
Increased HR
Narrowed pulse
rapid deep respirations
thirst
cool skin
diaphoresis
oliguria
decreased BS
restlessness hyperglycemia
Progressive shock stage
Compensatory mechanisms fail
cellular damage occurs
Anaerobic metabolism (metabolic acidosis)
Progressive shock stage S/S
Hypotension
Increased RR
Cold clammy skin
anuria
absent bs
lethargy
hyperglycemia
increased BUN / Cr
metabolic acidosis/ respiratory acidosis
dysrhythmias
Refractory Shock Stage
Inadequate tissue perfusion causing tissue hypoxia with ischemia and necrosis
IRREVERSIBLE
two or more organ systems fail
MODS Occurs
Septic Shock
life threatening organ dysfunction caused by a bodys response to an infection
cause: e clo, staph
When it comes to Sepsis rememver its about TIME..
temp
infection
mental decline
extremely ill
Sepsis Tx:
Obtain Lactate levels, blood culture
ABX
Crystalloid fluids (NS, LR, D5W)
Vasopressors
Improve tissue perfusion
Fluid Administration
Optimize metabolic enviornment
