Week 7 - Sepsis Flashcards
1
Q
Diagnostic markers (5)
A
Need at least 2:
- Temp > 38.3
- WBC < 4,000 or > 12,000
- HR > 90
- > 10% bands
- RR > 20
2
Q
Most common lung cause
A
Pneumonia
3
Q
Most common GU cause
A
UTI
4
Q
Severe sepsis defintion
A
Presence of acute organ dysfunction
5
Q
Severe sepsis s/s (9)
A
- thrombocytopenia, coagulopathy
- AMS
- oliguria, AKI
- respiratory failure
- hypotension, hypoperfusion
- lactate > 4
6
Q
Septic shock definition
A
Hemodynamic instability despite fluid challenge
7
Q
Septic shock s/s (3)
A
- SBP < 90 (or 40 below baseline)
- MAP < 65 after 30 mL/kg fluid bolus over 30 min
- multi organ dysfunction
8
Q
3 hour bundle (4)
A
- measure lactate
- IV broad spectrum Abx
- 30 mL/kg crystalloid
- MAP goal > 65
9
Q
6 hr bundle (3)
A
- vasopressors for MAP 65 or higher
- CVP, SvO2
- Re-measure lactate
10
Q
First choice of vasopressor for sepsis
A
Norepinephrine
11
Q
In sepsis would you be hyper or hypoglycemic?
A
Hyperglyecmic
12
Q
MT complications (7)
A
- reaction
- coagulopathy
- hypocalcemia
- hypomagensemia
- hypokalemia
- hypothermia
- metabolic acidosis
13
Q
Why does dilutional coagulopathy occur in a MT?
A
- Trauma –> DIC
- Hemorrhagic shock –> fluid shift from interstitial to intravascular –> dilution of coagulation factors
- But the PRBCs you’re giving don’t have platelets or clotting factors (coagulation factor deficient)
14
Q
Why does hypocalcemia occur in a MT?
A
- Citrate (an anticoag) in PRBCs binds with Ca –> lowers ionized level
15
Q
S/s of hypocalcemia
A
- Tetany like manifestations
- Myocardial depression
