Flashcards in Sepsis Deck (18):
What are the possible risk factors which could lead to sepsis?
Ventilation (risk of pneumonia)
Risk of bowel perforation
What are the nursing actions to help reduce the risk factors for sepsis?
Mobilise pt as soon as possible
Remove any unnecessary lines
Regularly check wound site
Nutrition - dietician r/v and encourage eating
Challenge bad behaviours by others
What does the NICE Guidelines (2007) for the handover of a pt require?
Summary of critical care stay
Monitoring and investigation plan
Plan of ongoing treatment
Physical state and rehabilitation
Psychological and emotional needs
What are the criteria for sepsis?
Glucose: > 7.7
Temperature: > 38.3 degrees or 20
WCC: >12 or
What information is required during handover?
Current obs, baseline and monitoring plan - how often, criteria for informing docs if deteriorates
Blood results - CRP, U+E (K, Na, Ca, Mg) ESR, INR, PTT, platelets,LFTs, Creat, Hb, ABG
Medication - antibiotics, analgesia, any specific blood levels needed, time critical meds
Check wound site
IVIs - date for replacement/insertion, skin intact
PMH - any allergies
Pt details - NOK
Key summary of critical care
Any communication barriers
What is sepsis?
An uncontrolled systematic response to infection that doesn't work normally
Can rapidly escalate
What is SIRS?
Systemic inflammatory response syndrome
What is the severe sepsis screening tool?
Used for new onset
What counts as infection?
Pneumonia, UTI, anything breaching the mechanical barrier of skin, C-diff, peritinitis, wound infection, meningitis, bacterial, viral, fungi, secondary infections, multi-resistant strains
What is the first line of priority to avoid sepsis?
What are the characteristics of sever sepsis?
Signs of SIRS which is interfering with O2 delivery to organs, leading to the organs shutting down
Drop in BP
What is the pathogenesis of sepsis?
1. Pathogen enters the body
2. Normal inflammatory response which is repeatedly triggered
3. Overriding inflammatory response which becomes hard to control
4. Cytokine chemical mediators
5. Coagulation triggered
6. Inside cell dysfunction/mitochondrial dysfunction
What are the symptoms of multi-organ dysfunction?
Altered mental state
Lungs become "leaky" = pulmonary oedema
Oedema all over the body
What causes the symptoms of sepsis?
Systematic vasodilation = less pressure in the blood vessels
Increased capillary permeability = hypovelimia
What are the priorities for a pt with suspected sepsis?
Sepsis care bundle
What is involved in the sepsis care bundle?
First 3 hrs = measure lactate level, blood cultures before antibiotics, administer fluids
First 6 hrs = not responding to fluid resus:CV line, HDU/ICU, measure O2 saturation of venous blood, apply vasopressors (noradrenaline)
What is involved in the sepsis 6
1. High flow O2 via non-rebreathe mask
2. Blood cultures (all devices, swabs and samples)
3. Give antibiotics (IV, 1 hr of diagnosis, broad spectrum)
4. Give fluids (30 mls per KG per hr, 500 ml bolus)
5. Check lactate and Hb (normal lactate =