Sepsis Flashcards
(35 cards)
What is Sepsis?
Condition where body launches large immune response to infection
What are the RF for Sepsis? (7 things)
- Very young / old (under 1 / over 75)
- Chronic conditions (e.g COPD / DM)
- Chemo / immunosuppressants / steroids
- Surgery
- Trauma / burns
- Pregnancy
- Medical devices (e.g catheters / central lines)
What does Sepsis cause pathophysiologically?
Systemic inflamm –> Affects functioning of organs
What is the main thing that is released in the pathophysiology of Sepsis?
Cytokines
What do Cytokines cause in Sepsis? (3 steps)
- Endothelial lining of blood vessels –> more permeable
- Fluid leaks out of blood –> Extracellular space –> Oedema
- Reduction in Intravasc volume
What does Oedema cause in Sepsis?
Reduction in O2 reaching tissues
How does Oedema in Sepsis cause reduction in O2 reaching tissues? (2 steps)
- Creates space between blood and tissues
- This reduces amount of O2 reaching tissues
What does Sepsis do in terms of coagulation?
Actives coagulation system
What does Activation of Coagulation system in Sepsis lead to? (2 steps)
- Deposition of Fibrin throughout circulation
- This compromises organ + tissue perfusion
What major complication can Activation of Coagulation system lead to in Sepsis?
Disseminated Intravasc Coagulopathy (DIC)
How can Sepsis cause Disseminated Intravasc Coagulopathy (DIC)? (3 steps)
- Consumption of Platelets + Clotting factors (used to to form clots within circ system)
- Thrombocytopaenia + Haemorrhages + X form clots
- Disseminated Intravasc Coagulopathy (DIC)
What does tissue hypoperfusion lead to in Sepsis, in terms of ABG results?
Rise in blood lactate
How does Sepsis lead to raised Lactate? (3 steps)
- Tissue is starving for O2
- Switches to Anaerobic resp
- Waste product of this = lactate
What are the numerical definitions of Septic Shock? (2 things)
Either:
1. Systolic BP less than 90 (despite fluid resus)
1. Lactate 4+
How should you Mx Septic shock?
Aggressive IV fluids
(to improve BP + tissue perfusion)
What should you do if BP + lactate levels not improving w IV fluids in Septic shock?
Send to ITU
What meds can ITU use to Mx Septic shock no responding to IV fluids?
Noradrenaline (inotrope)
How does Noradrenaline work in Mx of Septic shock?
Stimulates CVS –> improves BP + tissue perfusion
What is Severe sepsis defined as?
Sepsis + Organ dysfunction
What are examples of Organ dysfunction in Severe Sepsis? (7 things)
- Hypoxia
- Oliguria
- AKI
- Hypotension
- Thrombocytopaenia
- Coag dysf
- Hyperlactaemia (2+)
What scoring system done by nurses is used to pick up signs of sepsis?
NEWS score
Apart from NEWS score, what other signs of sepsis might you see @ exam? (9 things)
- Cough
- Tachypnoea
- Arrhythmias (e.g new onset AF)
- Wound discharge
- Cellulitis
- Non-blanching rash
- Mottled skin
- Cyanosis
- Dysuria / reduced urine output
What is usually the FIRST sign of sepsis?
Tachypnoea
What does a Non-blanching rash in Sepsis indicate?
Meningococcal septicaemia
