Flashcards in EXAM #2: PEDIATRIC SEPSIS Deck (29)
How do you tell the difference between a colonized patient and an infected patient?
Infection= inflammatory response to organism
What are the inflammatory signs?
5) Functio laeso (loss of function)
What are the lab markers for inflammation?
1) Increased WBC
What is the definition of a fever?
Temperature greater than 100.4 F or 38.0 C
When is the body temperature the lowest? Highest?
How does temperature vary with age?
Higher in infants
Where is the gold standard site to take a temperature?
How old does a kid need to be for TM temp. and oral temp?
TM= 2 months
Oral= 5 years
What is SIRS?
Systemic Inflammatory Response Syndrome
1) Temp. greater than 38
2) HR above 90 or 2SD above the mean for age
3) RR above 30 or 2SD above mean
4) PaCo2 less than 32
5) WBC greater than 15K or less than 5K
6) Bands greater than 10% WBC
What is sepsis?
SIRS + infection
What is bacteremia?
Viable bacteria in the blood
Note that viremia, fungemia, or parasitemia are all associated with sepsis
What is severe sepsis? What are the indications of severe sepsis?
Sepsis associated with organ dysfunction
- Mental status changes
- Lactic acidosis
What is septic shock?
Sepsis refractory to adequate fluid resuscitation
What is MODS?
Septic shock with altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention
What is early onset newborn sepsis?
Sepsis that occurs in first 6 days of life
What are the common organisms that cause early onset newborn sepsis?
Group B Strep
What are the risk factors for early onset newborn sepsis?
1) ROM greater than 18 hours
2) Maternal fever during labor/ chorioamionitis
3) Previous infant with GBS infection
4) Mom less than 20 y/o
5) Prematurity/low birth weight
What is chroioamionitis?
Inflammation of fetal membranes diagnosed by:
2) Fetal tachycardia
3) Uterine tenderness
4) Foul vaginal discharge
5) Maternal leukocytosis
What is late onset newborn sepsis?
Sepsis from 7-90 days
What is the treatment for early onset newborn sepsis?
Ampicillin + aminoglycoside
2nd generation cephalosporin
What is most likely to cause late onset newborn sepsis?
How is late onset newborn sepsis treated?
2nd or 3rd generation cephalosporin
What is occult bacteremia?
Condition in which bacteremia is identified in a "well appearing kid" that may fit a couple sepsis criteria
What is the most common cause of occult bacteremia?
What is the treatment for occult bacteremia?
1) Get WBC count
2) If high, get blood culture
3) Positive give IM ceftriaxone
*Give instructions to return immediately if condition worsens*
What is meningococcemia?
Neisseria meningitidis in the bloodstream
What are the symptoms of meningococcemia?
2) Petechia or purpura
When are the highest attack rates of meningococcemia?
- 6 months to 1 year
- College dorm/ military recruit