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3/4: YX - OSCE > Sepsis > Flashcards

Sepsis Flashcards

1
Q

What pathway is used in suspected sepsis?

A

Sepsis 6

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2
Q

What mnemonic can be used to remember the sepsis six?

A

BUFALO

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3
Q

What phrase can be used to remember the Sepsis 6?

A

‘Give three, take three’

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4
Q

What 3 things do you ‘give’ in suspected sepsis?

A

IV fluids
IV antibiotics
High flow oxygen

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5
Q

How should oxygen be administered in suspected sepsis?

A

15l/min through non-re-breathe mask

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6
Q

How should IV fluid challenge be administered in suspected sepsis?

A

500ml bolus over 15mins (or faster)

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7
Q

What is a good antibiotic to use in suspected sepsis?

A

Meropenem

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8
Q

What class of abx is meropenem?

A

Carbapenem

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9
Q

What is the mechanism of action of meropenem?

A

Inhibits cell wall synthesis

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10
Q

What 3 things do you ‘take’ in suspected sepsis?

A

Blood cultures
Measure urine output
Measure serum lactate

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11
Q

When should the sepsis screening tool be used?

A

If NEWS ≥3 or the patient looks acutely unwell

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12
Q

Why are loads of patients NEWSing ≥3 and no one cares?

A

Because the cause has to be likely due to an infection - lots of patients are NEWSing 3 for other reasons

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13
Q

If a patient NEWS ≥3 and likely infection what should be looked for?

A

Red Flag symptoms

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14
Q

What are Red Flag symptoms?

A 
Responds only to voice/pain/unresponsive
SBP ≤90
HR > 130
RR ≥25
Needs O2 to keep sats >92%
Non-blanching rash
Anuric for 18 hours
Lactate >2
Recent chemo
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15
Q

If a Red Flag is present what should happen?

A

Start Sepsis 6 Now!

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16
Q

If no Red Flags?

A

Check for Amber Flags

17
Q

What are the Amber Flags of Sepsis?

A 
Concerns about mental status
Acute deterioration in function
Immunosuppressed
Trauma/ surgery/ procedure in last 6 weeks
RR 21-24
SBP 91-100
HR 91-130 OR new dysrhythmia
Anuric for 12-18 hours
Temp < 36ºC
Clinical signs of wound, device or skin infection
18
Q

What should be done if 2 Amber Flags found (and consider if 1)?

A

Send bloods including U&E’s

Contact ST3 or higher

19
Q

If patient is an Amber Flag patient and has AKI what should be done?

A

Start Sepsis 6 Now!

20
Q

Is every Sepsis 6 treated patient septic?

A

No probably not but better be safe than sorry

21
Q

What should be done whilst treating for sepsis?

A

Undertake appropriate investigations for suspected infection and attempt to identify organism

22
Q

If an organism is identified what change should be made to management?

A

Switch eventually to a narrower spectrum antibiotic that organism has sensitivity to

3/4: YX - OSCE (19 decks)

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