Infection 3 Acute Sepsis Flashcards
(33 cards)
Sepsis definition
Characterised by a life threatening organ dysfunction due to a dysregulated host response to infection
Septic shock defintion
persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation
Signs of sepsis SEPSIS
Slurred speech
Extreme shivering/muscle pain
Passing no urine in 24 hours
Severe breathlessness
It feels like you’re going to die
Skin mottled or discoloured
Local infection signs
Rubor
Tumor
Calor
Dolor
Sepsis mortality rate
28.9%
What happens in sepsis?
Vasodilation - ^ blood flow > rubor + calor
Amplification
Capillary leakage
Who is at risk of sepsis?
< 1 year old
> 75 years old / very frail
Pregnant + post partum
Immunosuppressant patient
Acronym for effects on sepsis on organ systems
ABCDE
Airways
Breathing
Circulation
Disability
Exposure
Effects of sepsis on airways
No specific effect
Unless infection is in throat or neck
Effects of sepsis on breathing
- Tachypnoea
- Fluid + protein leak into interstitial tissue > lung oedema + decreased lung compliance
Tachypnoea meaning
High respiration rate
Effects of sepsis on circulation
- Hypovolaemia due to vasodilatation + leaky capillaries > hypotension
- tachycardia
- end organ damage
Effects of sepsis on disability + presentations
- decreased blood flow to brain
- confusion
- drowsiness
- slurred speech
- agitation
Effects of sepsis on exposure
- high temp due to hypothalamic response
- hypothermia in elderly
When should you screen for sepsis?
- clinician or carer is worried about patient
- NEWS2 score >5
- patient at risk of neutropenia
- evidence of organ dysfunction
What test can show evidence of organ dysfunction?
Lactate levels > 2mmol/L
What does NEWS2 measure?
- resp. rate
- O2 saturation
- systolic BP
- pulse rate
- level of consciousness
- temperature
What is red flag sepsis?
Patient at high risk of deterioration
If NEWS 2 >7 or 5/6 with another condition
What are the other conditions for red and amber flag sepsis?
And NEWS2 scores
- lactate > 2mmol/L
- chemotherapy in last 6 weeks
- organ failure
- patient looks very unwell
- patient is actively deteriorating
Red 5/6
Amber 1-4
What further reviews are needed in amber flag sepsis?
- bloods + review results
- senior clinical review within 1 hour
- antimicrobial + escalation plan within 3 hours
Management of sepsis
Sepsis 6
What are the sepsis 6?
3 in 3 out
1- senior help
2- give O2 if needed
3- send bloods
4- IV antibiotics
5- control IV fluids
6- monitor
O2 content equation
O2 content = [Hb] x SpO
What levels should O2 be?
When would you give O2?
Normal 94-98%
Give O2 if <92%
