Sepsis in hospital

Question 1

prompt recognition and the use of the x bundle can save lives and reduce the associated morbidity related to sepsis

Answer 1

sepsis six

Question 2

a patient has red flag sepsis if they have an aggregate news2 score of x or above

Answer 2

7

Question 3

a patient has red flag sepsis if they have an aggregate news2 score of 5 or 6 plus one of what following factors

Answer 3

lactate over 2
chemo in last 6 weeks
organ failure
patient looks unwell
patient actively deteriorating

Question 4

all sepsis six care bundle actions should be done in x hrs of recognition of red flag symptoms

Answer 4

1

Question 5

low clinical risk aggregate score

Answer 5

0-4

Question 6

low - medium score

Answer 6

3 in any sector

Question 7

medium clinical risk aggregate score

Answer 7

5-6

Question 8

high clinical risk aggregate score

Answer 8

7 or more

Question 9

sp02 scale 1 applies for most px, what is scale 2 reserved for

Answer 9

px w hypercapnic resp failure

Question 10

true or false aki is evidence of organ failure

Answer 10

true

Question 11

when should an antimicrobial prescription be reviewed and the patient switched to the oral route

Answer 11

when px is stable

Question 12

why is it important to regularly monitor patients renal function when they have sepsis

Answer 12

can cause impairment and may improve with treatment causing need for dose adjustment

Question 13

how can communication and management of sepsis patients be ensured

Answer 13

thorough documentation of treatment plans and effective handover

Question 14

patients with what condition represent the largest group of patients with sepsis

Answer 14

pneumonia

Question 15

which patient groups should news2 not be used in

Answer 15

children under 16 and pregnant women as physiological response to illness can be altered in these patients

Question 16

amber flag sepsis is defined as an aggregate news2 score of 5-6 or 1-4 with what following parameters

Answer 16

lactate over 2
chemo in last 6 weeks
organ failure
patient looks unwell
active deterioration

Question 17

the presence of amber flag sepsis should prompt you to send and review blood tests, what things would this include

Answer 17

fbc, ue, crp, clotting factors

Question 18

who should you escalate amber flag sepsis to and within what time frame

Answer 18

senior clinicain within 1 hr

Question 19

in the case of amber flag sepsis abx treatment if needed should be adminstered with a plan for source control and escalation within x hrs

Answer 19

3

Question 20

what is the most severe form of sepsis

Answer 20

septic shock

Question 21

in most cases giving x as part of the sepsis six care bundle will resolve septic hypotension

Answer 21

iv fluid replacement

Question 22

septic shock is sepsis and

Answer 22

refractory hypotension

Question 23

when looking for sepsis what drug class can mask tachycardia associated with an inflammatory response

Answer 23

bb

Question 24

what drug could be used to reduce a fever that is masking fever

Answer 24

paracetamol

Question 25

what is cryptic shock

Answer 25

lactate over 2 in presence of normal blood pressure

Question 26

in a patient with sepsis myocardial depression may occur which will cause initiation of acute coronary syndrome treatment. In patients that survive cardiac function will usually recover within what time period

Answer 26

7-10 days

Question 27

most common cause of puerperal sepsis

Answer 27

bacterial endometritis

Question 28

what common sites does puerperal sepsis affect

Answer 28

genital tract and uterus

Question 29

list some common pathogens that cause sepsis in pregnancy

Answer 29

strep pyrogens e coli staph aureus strep pneumoniae mrsa esbl

Question 30

what is included in the sepsis six

Answer 30

ensure senior clinician attends admin o2 if needed obtain iv access and take bloods give iv abx and think source control give iv fluids monitor

Question 31

at least 2 sets of blood cultures should be taken in what 2 bottles

Answer 31

aerobic and anaerobic

Question 32

should you wait for blood cultures before giving abx

Answer 32

no

Question 33

why should culture bottles not be overfilled

Answer 33

can -> false positive results

Question 34

4 important considerations

Answer 34

allergy recent travel recent hospital admission resistance and sensitivities

Question 35

all patients should recieve a full first dose/ loading dose of abx within x hr of diagnosis

Answer 35

1

Question 36

if the source of sepsis could be amenable to drainage aim to achieve this asap but definitely within x hrs

Answer 36

12

Question 37

in those aged 16 years and above what fluid should be given and over what period

Answer 37

500ml bolus over less than 15 mins

Question 38

what type of iv fluid should be given

Answer 38

crystalloid that contains sodium in range of 130-154 like hartmans or sodium chloride 0.9%

Question 39

at what time period should patients be reviewed and have their management plan documented including the next review or stop date

Answer 39

48-72hrs

Question 40

give 2 places where you should document that abx is for the treatment of sepsis

Answer 40

prescription and medical notes

Question 41

all patients should receive first dose of abx regardless of renal function true or false

Answer 41

true

Question 42

what band should patients wear to identify allergy status

Answer 42

red

Question 43

you should ask about recent travel within x months

Answer 43

12

Question 44

the sepsis 6 toolkit provides management for the x hr of diagnosis

Answer 44

first

Question 45

all sepsis patients should be reviewed after an hour to ensure

Answer 45

treatment is working and source under control

Question 46

fluid resus regimen for adult patient with Red Flag sepsis as part of the Sepsis Six® Care bundle?

Answer 46

500 ml of Hartmann’s or sodium chloride 0.9% over less than 15 minutes.

Question 47

which NEWS2 score indicates Red Flag sepsis and initiation of Sepsis Six Care bundle?

Answer 47

aggregate 7 or above, or aggregate 5 or 6, plus any ONE of the following: - Lactate > 2 mmol/litre - Chemo in last 6 weeks - Other organ failure evident (e.g. AKI) - px looks extremely unwell - px actively deteriorating

Question 48

for amber flag sepsis in adults, what should be done

Answer 48

full set of bloods should be sent

Question 49

How quickly should the actions of the Sepsis Six® care bundle be completed following recognition of Red Flag sepsis?

Answer 49

60

Question 50

Cryptic shock is where patients are found to have a high X concentration in the presence of a Yblood pressure

Answer 50

lactate, normal these patients may have sepsis and require urgent treatment.

Question 51

news score can be used to assess what

Answer 51

clinical deterioration over a period of time