Sepsis In Adults

Question 1

Define sepsis

Answer 1

Life threatening organ dysfunction caused by a dysregulated host response to infection

Question 2

What component of a blood gas could indicate the severity of sepsis?

Answer 2

lactate
(>2mmol/L)

Question 3

What is the difference between the management of hypovolaemic + septic shock?

Answer 3

• Adequate volume resuscitation will fix hypovolaemic shock but NOT septic shock
• Septic shock needs vasopressors to help

Question 4

What changes occur in the body as a result of sepsis?

Answer 4

ABCDE
- Airways: not much of an affect
- Breathing: Tachypnoea + oedema
- Cardiovascular: hypovolaemia (due to vasodilation + capillary leakage > hypotension) + tachycardia
- Disability: reduced blood flow to brain
- Exposure: high temp (low temp in elderly)

Question 5

What makes up severe sepsis?

Answer 5

Systemic inflammatory response syndrome + organ dysfunction

Question 6

What is involved in sepsis 6?

Answer 6

• get senior help
• O2 if required
• take bloods (lactate levels)
• IV antibiotics
• IV fluids
• monitor (urine output)

Question 7

What is classified as red flag for sepsis?

Answer 7

NEWS2 7 or above OR NEWS2 5/6 with one of:
- lactate >2mmol/L
- patient looks very unwell
- chemo in last 6 weeks
- other organ failure evident
- patient is actively deteriorating

Question 8

What is a SOFA score?

Answer 8

Assess how 6 organ systems are functioning

Question 9

Define septic shock

Answer 9

A clinical construct of sepsis with persisting hypotension requiring vasopressin (vasoconstrictors) + serum lactate >2mmol/L

Question 10

What is involved in systemic inflammatory response?

Answer 10

At least 2 of:
- temp >38 or <36
- tachycardia
- Tachypnoea
- high or low white cell count