week 4 sepsis Flashcards
what is the leading cause of sepsis?
gram -ve bacteria
what is sepsis?
symptoms from systemic infection
life-threatening organ dysfunction due to pathogen and bad response to infection
septic shock
severe sepsis
high risk of mortality
due to physiological compensatory mechanisms
sepsis 6 treatment
Give 3:
Oxygen
IV fluids
IV antibiotics
Take:
Lactate
blood cultures
urine output
what is SOFA
sequential organ failure assessment
suspected inflammation + change in 2< from baselines:
respiratory, haematology, liver, renal, brain, cardiovascular
pathophysiology of sepsis
infection of pathogen
inflammatory response
coagulation cascade
physiological compensation
metabolic compensation
compensated shock?
normal blood pressure = treat
decompensated shock?
low bp = difficult to treat
acute inflammation?
response to tissue injury, infection or irritation
rapid and short lived
symptoms of acute inflammation?
fever fatigue loss of appetite
features of acute inflammation
loss of appetite
redness
heat
swelling
pain
what is blood pressure?
pumps blood through the body, tissues, organs
it is proportional
BP= (heart rate x stroke volume) x systemic vascular resistance
what happens during vasodialation?
decrease in vascular resistance
skin is well perfused
organs are not
what happens in vasoconstriction?
as sepsis occurs
increase in peripheral SVR and maintains vital organ perfusion
what happens if there is a fall in SVR
compensatory tachycardia and increase in Stroke volume (SV) to maintain BP
List 3 red flags for sepsis?
· 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
what are the 2 common presentations to septic shock
Warm and cold shock
What are the common infectious causes of sepsis
Pneumonia
Urinary tract
Abdomen
What are the effects of sepsis on the brain
Confusion
raised blood sugar
What are the effects of sepsis on the brain
Confusion
raised blood sugar
What are the effects of sepsis on tissues
Increased anaerobic respiration
What are the effects on the lungs in sepsis
Increased respiratory rate
shortness of breath
difficulty taking breaths
What are the principles of management of TSS?
Fluids
antibiotics
removal of source of toxins
What are the vascular changes that occur in response to sepsis?
Vasodilatation
increased vascular permeability
increased adhesion of white blood cells
