Sepsis

Question 1

What are the risk factors for sepsis?

Answer 1

• Elderly (75+) or young (0-12months).
• Impaired immune system.
• Breach of skin integrity.
• IV drug users.
• Indwelling lines or catheters.
• Pregnancy/termination.
• Diabetes.
• Asplenic (abnormal activity or loss of spleen)

Question 2

Define colonisation

Answer 2

Presence of a microbe in the human body that does not cause infection or specific immune response

Question 3

Define infection

Answer 3

Occurance of inflammation due to presence of a microbe

Question 4

Define septicaemia

Answer 4

Presence of variable microbes in the blood

Question 5

Describe the criteria for sepsis diagnosis

Answer 5

Documented infection site (BCs don’t need to be pos) and two or more of the following:

• Temp of over 38 or below 36.
• Heart rate > 100bpm
• Respiration > 20/min
• Leukocyte count > 16000/mm3 or <4000/mm3.

Question 6

What are some parts of the body you would investigate in sepsis?

Answer 6

CNS, CV, Respiratory, renal, GI, metabolic, haematology and skin.

Question 7

What is the sepsis 6?

Answer 7

A set of investigations;
1) Take blood cultures.
2) Measure hourly urine output
3) IV fluid challenge
4) broad spectrum antibiotics
5) measure serum lactate and haemoglobin
6) Administer high flow oxygen. 
Should be done in first hour.

Question 8

How can you diagnose an infection for sepsis?

Answer 8

• Blood tests (WCC, CRP, platelets and clotting).
• Microbiology (culture of blood, stool urine, wound swab, tissue, CSF or sputum)
• Viral studies (NAAT/PCR)
• Serology (for antibodies)

Question 9

What indicates septic shock?

Answer 9

Hypotension and raised lactate

Question 10

What is the treatment for sepsis?

Answer 10

Blood cultures before prescribing then review when results are available. IV broad spectrum antibiotics within 60mins of recognition of sepsis. IV fluids, Oxygen and vasopressors