Test 2: Sepsis

Question 1

Normal inflammatory Response

Answer 1

Redness, swelling, warmth

Question 2

SIRS

Answer 2

Increase R, HR, temp
Decrease BP

If patient appears to have SIRS, treat them like they already have shock

Question 3

SEPSIS Patho

Answer 3

Trauma
Bacteria Invades Sterile tissue
SIRS
Organism invades systemically
Systemic Inflammation
Massive Vasodilation causing…
1) Cytokine Storm (increase wbc)
2) Septic Shock

Body still tries to compensate w/ barro receptors BUT NOT ABLE to due to massive vasodilation

Question 4

1 Hour Sepsis Bundle

Answer 4

Measure lactate level
Culture BEFORE Antibiotics
Broad Spectrum Antibiotics
Rapid Crystalloid Fluid - 30ml/kg for hypotension or lactate >34
Vasopressors during or after fluid resus. to maintain map >65

Question 5

Shock Treatment

Answer 5

Assess ABC - fix underlying problem
Crystalloid Fluids - LR or NS
Vasopressors
Inotropic Meds
Blood products
Nitroglycerine

Question 6

How do we treat fluid overload due to fluid resusitation?

Answer 6

Stable = hemodialysis
Unstable 24hr CRRT

Question 7

Vasopressors in Shock

Answer 7

Noreepi (Levofed) = shunting to increase myocardial contraction - side effect is BF shut off to other organs

Dopamine

Assess for chest pain

Question 8

Inotropic Medicine

Answer 8

Designed to increase O2 demand

Millidrine
Dobutamine

Question 9

Blood Products

Answer 9

PRBC
FFP
Platelet
Albumin

Question 10

How to treat Distributive Shock

Answer 10

Include Racemic epi to stimulate a and b adrenergic receptrs

Xoponex
Bronchodilator
Corticosteroid
Protonix
Benadryl