Sepsis and Infection (Adult) Flashcards
(27 cards)
What are the care objectives for sepsis?
- Identify and treat patients with clear signs of sepsis
- Risk stratify patients presenting with infection to inform and appropriate disposition
Recite the sepsis and infection CPG for adults
What is qSOFA and what are the components?
- qSOFA (Quick sequential organ failure score)
- used to identify patients with infection who have increased risk of sepsis, ICU admission and mortality using criteria that are easily available in the out out hospital environment
- Hypotension (≤ 100mmHg)
- ACS (GCS <15 unless normal for patient)
- Tachypnoea (RR ≥ 22)
What is the news2 and what does it mean?
- A risk score than combines a range of VS abnormalities into a single measure of risk
- More reliable measure of the risk of sepsis, deterioration and death than any single vital sign alone
- NEWS2 0-2 - Low risk
- NEWS2 3-4 - Moderate risk
- NEWS2 5-6 - High risk
- NEWS2 7+ Very high risk
What are the indications for Normal saline?
What are the contraindications for Normal saline?
What are the precautions for Normal saline?
What are the side effects of normal saline?
What are the indications for Ceftriaxone?
What are the contraindications for Ceftriaxone?
What are the precautions for Ceftriaxone?
What are the side effects for Ceftriaxone?
Why do we use NaCl in patients with sepsis?
- The body’s response to infection causes blood vessels to leak and dilate, leading to low blood pressure and poor organ perfusion
- NaCl is used for fluid resuscitation because it helps restore circulating blood volume, supports blood pressure and improves oxygen delivery to the tissues
- Its isotonic, so it stays in the bloodstream longer, making it effect for rapid volume expansion
Why do we use Ceftriaxone in patients with Sepsis?
- Broad spectrum antibiotic
- Effective against a wife range of Gram-positive and Gram-negative bacteria, including many common sepsis causing pathogens.
- It is often used as an emperic treatment - meaning given before the exact bacteria are identified - because of its strong coverage, good tissue perfusion, and long half-life.
- This makes it a reliable and convenience option in the early management of sepsis
Does the O2 thearpy guideline apply to this presenation?
- In severe sepsis = critical illness
- Or if evidence of hypoxaemia
What are the indications for IV insertion
What are the contraindications for IV insertion
What are the precautions for IV insertion
What are 3 differential diagnoses for sepsis?
- Sepsis
- Infection
- Heat stroke
What are some care pathways/treatment options?
- Reassurance
- NEWS1 score 0-2 (low risk) → Safety netting, self-care advice, consider referral to GP
- NEWS2 score 3-4 (moderate risk) → VVED vs transport
- NEWS2 score 5+ (high risk) → transport to ED, consider Mx as per sepsis
- NEWS2 score 7+ (sepsis or septic shock) → O2, NaCl, transport to ED signal 1 with notification +/- ceftriaxone if > 60 mins from hospital, MICA = aramine, noradrenaline + adrenaline
- Reassessment
What are some extrication considerations?
- Try not to walk, posutral drop
What are some escalation of care considerations?
- Now in the back of the ambulance what are you going to do with them?
- Continue to monitor VSS
- O2
- IVC
- NaCl
- Signal 1 transport with notification
- If > 60 mins from hospital = ceftriaxone
- +/- MICA for aramine, norad, adrenaline
- What is your scene time?
- How far is MICA - am I waiting or loading and going?
- How far is the hospital?
What secondary surveys are applicable to this case?
- NEWS2
- qSOFA
- AEIOUTIPS
What are the indications for preparing medications for administration
