Sepsis SIRS Flashcards
(57 cards)
Sepsis is
A Life threatening syndrome that arises when the boyd’s response to infection injures it’s own tissues organs
4 Key interventions to SIRS
Labs and Diagnostics (CBC, Serum glucose etc.) - When sepsis labs are drawn it NEEDs to include blood cultures AND lactate
Begin Pt on broad spectrum antibiotics (IV) then more specific
IV Fluid Bolus (Rapid admin of IV fluid) 30mLs/Kg
Monitering
SIRS Criteria
Does the pt have any two or more of the follow SIRS criterea, AND if they have a suspectd/confirmed source of infection if so, they are at risk of developing sepsis
HR greater than 90BPM
RR greater than 20BrPM
Temp Greater than or equal to 38C or less than 36C
WBC greater than 12.0 or less than 4.0 (x10-9)
Altered Mental status (i.e. GCS)
How dangerous is Sepsis
SIRS 7% mortality
Sepsis 16%
Severe Sepsis 20%
Septic Shock 46%
How to objectify altered cognition
Glascow Coma scale
Septic Shock
A subset of sepsis
When sepsis does not respond to intervention
Characterised by consistent HOTN depsite adequeat fluid reuscitation and inadequate tissue perfusion (Bloodflow) resulting in tissue hypoxia
Mismatch bw O2 supply and demand
1/5 people in the world that die are from
Sepsis related
What is the most important thing in ttrearting sepsis
Speed is life
Key goals when recognixing and responsding to sepsis in pts
Timely recognition of early infection
Early treatment with antibiotics/IV fluids
Appropriate escalation to high acuity/ICU
Normal Inflamm response
Defence against injury, injuction or allergens
Localized inflammation
Results in Tissue repair
Inflammatory cascade
In
SIRS stands for
Systemic Inflammatory Response syndrome
SIRS
Exaggerated inflammatory response
A warning sign of a looming crisis
(Pre-sepsis criteria)
Non-specific response to infectious AND non-infectious insults
How do we identify if a pt might haver a suspected source of infection
Symptoms such as
Cough/sputum/chest pain/shortness of breath
Abdominal pain/distension/vomiting/diarreah
Dysuria/frequency/indwelling catheter
Skin or joint pain/swelling
Central Line
Mottled skin/cold extremities
Why is blood taken if systemic infection is supsectedq
BC if a local infection turned systemic it likely would have travelled vbia blood stream
SIR vs SEPSIS
If a suspected or known pathogen is identified then it is diagnosed as SEPSIS
Increas
Pts more at risk for SEPSIS
Older pts, the very young
Immunosuppressants (i.e. corticosteroids)
Pts with multiple chronic comorbidies
Pts w/ invasive devices in (Peritoneal, catheter, central line etc.)
Infection source examples
Lungs - i.e. pneumonia
Urinary Tract -
Abdomen-
Skin and Soft Tissue
Central Lines
Peritoneal
Etc.
What is Sepsis
When some type of infection develops into a systemic inflammatory response
Septic Shock
Severe sepsis w/ HOTN that does NOT resolve despite IV fluid resuscitation
HOTN defined as
Systolic BP less than 90mm Hg and or Lactate greater or = to 2.0 mmol/L
MAP (Mean arteriole pressure) : less than 65 mm Hg
What lab cultures do we ALWAYs need to ensure are drawn in query sepsis?
Blood culture, venous blood gas and lactate
Also a CBC, CRP, Procalcitonin, arteriole blood gas (meausres blood pH), glucose level
A specific sample if source location suspected (I.e urine sample if catheter is present)
MAP
Mean average pressure in pts arteriers during one cardiac cycle, better indicator of tissue perfusion than systolic pressure
What is lactate
A chemical produced by body to fuel the body during stress, commonly asscoiated with sepsis
An important indicator of a septic pts progress (and effectiveness of the treatment)
Over 4 is associated with mortality of 25%
