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Flashcards in Sepsis Deck (56)
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1

What is the symptom sieve for patients with an altered mental state?

Primary neurological
Infection
Cardiorespiratory
Gastrointestinal
Metabolic/endocrine
toxins
Psychiatric

2

What is an A-E assessment?

An A-E assessment is conducted when encountering an unwell patient, ensuring that life threatening issues are identified and systematically treated.
Airways
Breathing
Circulation
Disability
Exposure

3

What are the 5 assessment criteria for airways?

1) There may be paradoxical chest and abdominal movements
2)Use of accessory muscles
3) Partial obstruction --> Noisy breathing (snoring, stridor, wheeze), with diminished air entry.
4) There are no breath sounds at the nose or mouth in total obstruction
5) Central cyanosis is a late sign

4

What breathing noise patterns are heard in patients with a partial obstruction?

Snoring, stridor and wheeze

5

What breath sounds can be heard in patients with total obstriction?

There are no breathing sounds

6

What is the latest sign of airways assessment?

Central cyanosis

7

What are the 5 actions for airways?

1) Airway manoeuvres -head tilt and chin lift or jaw thrust.
2) Suction to remove debris (Do not use fingers)
3) Simple airway adjuncts  Nasopharyngeal airway, oropharyngeal (Guedel). Supraglottic airway (iGel).
4) Advanced airway interventions  Intubation, emergency surgical airway
5) Give oxygen at high concentration

8

A decreased GCS <8 requires what?

Intubation

9

How should oxygen saturation be measured?

With a pulse oximeter , and count RR

10

A trachea deviation may indicate what pathology?

Pneumothorax or large effusion on the contralateral side or collapse on the ipsilateral side.

11

What percussion pattern is heard in patients with pneumothorax?

Hyperresonance

12

Dullness in percussion suggests what?

Consolidation of pleural fluid.

13

In a pneumothorax, what chest sounds are heard?

Absent or reduced sounds.

14

What is the emergency treatment for pneumothorax?

Chest drainage

15

What is the emergency treatment for anaphylaxis?

Adrenaline

16

What is the emergency treatment for an opioid overdose?

Naloxone

17

What is the %was oxygen saturation target for critically ill patients?

94%

18

What should be used to improve ventilation and oxygenation in patients if the depth of breathing is insufficient?

Bag-mask or pocket mask

19

Why should patients with COPD be on oxygen between 88-92%?

Patients with COPD have chronic hypercarbia, relies on hypoxic drive. High flow oxygen can remove their driving factor for ventilation  Respiratory distress

20

What is considered to be the primary cause of circulatory failure?

Hypovolemia

21

Why is there an elevated heart rate in hypotensive patients?

Physiological response of atrial stretch and baroreceptors sending vagal sympathetic stimulation to the cardio-respiratory control centres in the medulla  Increased sympathetic activity of the heart, release of NA onto the SAN.

22

What ECG abnormality will illustrate a patient experiencing an MI or ischaemic related change?

ST-elevation

23

What is the parameter for a normal capillary refill time?

Less than 2 seconds

24

How is the capillary refill time measured?

Apply cutaneous pressure for 5 seconds on a fingertip at heart level to cause blanching  Time how long it takes for the skin to return to its previous colour after releasing. A normal CRT <2 seconds. Prolonged CRT suggests poor peripheral perfusion.

25

What does an elevated JVP suggest?

Heart failure or fluid overload.

26

A barley palpable central pulse suggests what?

Poor cardiac output.

27

What does a bounding peripheral and central pulse indicate?

Sepsis

28

What blood test parameter is used to measure tissue perfusion?

Lactate level

29

What are the four types of shock?

Hypovolemic
Cardiogenic
Obstructive
Distributive

30

What is a hypovolemic shock?

(Decrease in the volume of blood, as occurs after internal or external haemorrhaging, burns, dehydration or severe vomiting/diarrhoea).