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Infection 2023 > Sepsis > Flashcards

Sepsis Flashcards

1
Q

What is sepsis?

A

Life threatening organ dysfuntion due to dysregulated host response to infection (damages its own tissues and organs)

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2
Q

What is septic shock?

A

Subset of sepsis

Circulatory, cellular and metabolic abnormalities which substantially increase mortality

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3
Q

Reasons for definitions:

A

Common language improves communication
Educate the public
Establish criteria and thresholds
Determine eligibility for clinical trials

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4
Q

Simple terms: what is sepsis

A

Physiological responses to infection
Inflammation
Dysregulated immune system

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5
Q

What happens in local infection?

A

Rubor (red)
Calor (hot)
Dolor (pain)
Tumor (swelling)

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6
Q

What happens in sepsis?

A

Widespread inflammation:
Capillary leakage = oedema (plasma proteins leave capillary and draw water into interstitial space)

Vasodilation = redness and heat

Amplification of immune cells

ACROSS THE WHOLE BODY

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7
Q

Effects of sepsis on airways

A

No specific unless infection arises from throat/neck

Decreased consciousness could mean airway problems

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8
Q

Effects of sepsis on breathing

A 
Tachypnoea (raised respiratory rate)
Lung oedema (fluids and proteins leaking out)
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9
Q

Effects of sepsis on circulation

A

Hypovalaemia (decreased circulating blood) from capillary leakage and vasodilation
Hypotension
Tachycardia
Organ damage - not perfused

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10
Q

Blood pressure equation

A

Cardiac output x vascular resistance

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11
Q

Effects of sepsis (disability)

A 
Reduced blood flow to brain
Confusion
Slurred speech
Agitation
Anxiety
Low level of consciousness
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12
Q

Effect of sepsis (exposure)

A

Hyperthermia (hypothalamic response to infection)

Hypothermia (<36) in ELDERLY

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13
Q

6 signs of sepsis

A 
S - slurred speech/confusion
E - extreme shivering or muscle pain
P - passing no urine 
S - severe breathlessness
I - it feels like you are going to die
S - skin mottled/discoloured
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14
Q

Who is at risk of sepsis?

A

Very young
Elderly
Pregnant/post partum (last 6 weeks)
Impaired immune system - illness/drugs

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15
Q

When do you think sepsis?

A

Triggering early warning score
Looks ill / relative concerned
Signs of infection

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16
Q

How are patients that are at risk of deterioration identified? (Sepsis)

A

National Early Warning Score (NEWS2)

17
Q

NEWS2 physiological measurements

A 
Respiration rate
Oxygen saturation
Systolic blood pressure 
Pulse rate
Level of consciousness / new confusion
Temperature

(ROSPLT)

18
Q

What is red flag sepsis?

A

High likelihood of organ dysfunction
High risk of deterioration
Not necessarily sepsis but could be

19
Q

What is the sepsis 6?

A

3 IN 3 OUT

In: antibiotics, fluids, oxygen

Out: blood culture, lactate & Hb, urine

20
Q

How fast should sepsis 6 be done?

A

Within the hour!!!

Each hour delay increases mortality 7.6%

21
Q

What occurs after you take a blood culture?

A 
Collect sample
Incubate 
Detects presence of CO2 (if CO2 produced = bacteria present)
Gram stain 
Sensitivity test
22
Q

Supportive investigations sepsis

A 
FBC
Urea
Electrolytes 
Blood sugar
Liver function test 
CRP
Coagulation tests 
Blood gases
23
Q

Specific investigations

A

Cerebrospinal fluid (CSF)
Throat swab
PCR

24
Q

How is cerebrospinal fluid obtained and tested?

A

Lumbar puncture (between L3-4 or L4-5)

Estimate glucose and protein
(Low glucose = bacteria, high protein = bacteria)

Microscopy (RBC, WBC)

Gram stain

PCR

25
Q

Meningococcus (cause and stain)

A

Neisseria meningitidis
Gram negative diplococcus

Outer membrane = endotoxin

26
Q

Treatment and prevention of Meningococcus

A

Antibiotics (that cross blood brain barrier) = Ceftriaxone

Vaccination

Prophylaxis for close contacts

Notify public health (notifiable disease and organism)

27
Q

3 ways mengititidis can act

A

First need to aquire

Clearance
Carriage (25% young adults)
Invasion

28
Q

How is meningococcus spread and how does it evade?

A

Aerosols
Nasopharyngeal secretions

Evades immune response by preventing phagocytosis

Infection 2023 (29 decks)

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