Summary Of Care Delivery: A Case Study

According to Jarden (2010) it is paramount a systemic approach of care delivery is utilised when treating critically ill patients. The Resuscitation Council (2010) suggest that healthcare professionals should utilise the ABCDE approach when assessing and treating patients. The first stage of the ABCDE process was to assess Shelia’s airway and breathing. As Shelia was able to communicate to the nurse, this established that the airway was patent, however Shelia’s respiration rate at 28 is seriously elevated. The pattern of the breathing is rapid and SaO2 checked is 90% on air. The next step to assess Shelia’s circulation, blood pressure at 90/50 and poor capillary refill > 2 seconds. At the disability stage of the process Shelia’s BM was obtained …show more content…
According to Surviving Sepsis Campaign (2013) by utilising a care bundle in the management of sepsis, this simplifies the complex process required to treat critically ill patients. They state the implementation of the sepsis six bundle has reduced mortality in patients with sepsis by 25 percent. According to Robson and Daniels (2013), it is estimated that sepsis claims the lives of over 37,000 people each year in the U.K, a rate of incidence that has increased 13% over the last ten years. Daniels and Robson (2015) state the current cost for the NHS due to sepsis equates to over £2.5 billion per annum. The definition of sepsis is the presence of Systemic Inflammatory Response Syndrome (SIRS) criteria in the patients with a suspected or diagnosed new infection. Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnoea and change in blood leucocyte count (Comstedt et al, 2009). When sepsis affects one or more organs this defines severe sepsis (Surviving Sepsis Campaign, 2013). The most common cause of sepsis is bacteria, however virus, fungi and parasites can also be the cause. Sepsis usually begins from cellular injury from an infection or toxin that causes a profound inflammatory response. Inflammatory mediators involved in this response are TNF …show more content…
Lee (2010) states in order to replace the intravascular volume deficit in patients suffering from sepsis, it is paramount to administer an enormous amount of intravenous fluid in order to decrease complications such as tachycardia, hypotension, acute kidney injury, and organ failure. Although this treatment is critically important in assuring intravascular volume is regained, according to Bouchard et al (2009) there is a sufficient amount of evidence to suggest that fluid overload may be damaging to critically ill patients. They suggest respiratory failure, increased cardiac demand, and peripheral oedema are all consequences of fluid overload and patients with underlying cardiac and respiratory conditions should be monitored intensely when being fluid resuscitated. Due to Shelia having an underlying cardiovascular condition it is vitally important that she is regularly monitored for any signs of fluid overload. An indwelling urinary catheter was inserted in order to monitor Shelia’s urine output as directed by the Sepsis Six Bundle, Lee (2010) states in all patients with sepsis, urine output should be closely monitored as it is a marker for adequate renal perfusion and cardiac output. A strict fluid balance was put in place to monitor Shelias input and output. According to a recent study by Sirvent et al (2015) fluid therapy at the onset of sepsis is the first