Sepsis

Question 1

What is sepsis?

Answer 1

Overactive and dysregulated response to infection. Pathogenic germs or toxin leave local site of infection and enter circulatory system.

Widespread inflammation caused, can damage tissues and organs.

3 stages sepsis, severe sepsis, septic shock.

Question 2

Systemic Inflammatory Response Syndrome (SIRS)

Answer 2

Cytokines trigger systemic inflammation response

Question 3

Septic Shock

Answer 3

Several organs stop functioning sequentially or simultaneously.

Cardio-circulatory failure sudden drop in BP.

Question 4

SIRS Symptoms (2 or more diagnosis of sepsis)

Answer 4

Fever 38+
Hypothermia 36-

Tachycardia 90 beats per min+

Tachypnoea 20 breaths per min+

White blood cell abnormalities leucocytosis, above 12,000cells per mm3.
Leukopenia less than 4000cells per mm3.

Question 5

SEPSIS SIGNS

Answer 5

Clammy or sweaty skin (temp up)
Shivering, fever or very cold (temp down)
Short of breath (tachypnoea)
Increases heart rate (tachycardia)
Extreme pain or discomfort.
Confusion or disorientation.

Question 6

Septic Shock Signs

Answer 6

Systolic blood pressure less than 90mmHG

Mean arterial blood pressure less than 65 mmHG

Drop in SBP (systemic blood pressure)

Elevated lactate levels more than 4 mmol/L (anaerobic respiration occuring)

Question 7

Sepsis 6 (performed in 1 hour)

Answer 7

Take (3):
-blood cultures (before antimicrobial dose)
-blood tests (including POC lactate)
-urine output (perfusion status assessment)

Give (3):
-oxygen (if needed)
- I.V fluid (if deficit)
- I.V antimicrobials

Question 8

Management of Sepsis

Answer 8

-broad spectrum antibiotics
- surgical intervention if needed,
- aggressive support in intensive care unit
- steroids
- Tight glycemic control
- Activated protein C (anti inflammation, anti-thrombotic, profibrinolytic