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12 Cards in this Set
- Front
- Back
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Identify and state the criteria for sepsis.
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A sorce of infection
PLUS TWO OR MORE = Tachycardia Abnormal temp High Resp Abnormal WBC |
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Describe the signs and symptoms of sepsis and the underlying pathophysiology
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Sd
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. Briefly explain how the progression from SIRS to septic shock.
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Warm - Cold Phase.
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Outline the pharmacological and non pharmacological treatment and management of sepsis/septic shock.
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Oxygen and Fluids to increase BP
Removal of lines Debrid wound Keep warm |
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What is Sepsis
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Systemic Inflammatory Response Syndrome (SIRS) plus a documented infection site (positive culture for organisms from that site)”
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What causes Sepsis
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Systemic reaction to infection
95% caused by Bacteria 5% caused by fungi Candida (causative agent for thrush) is one of the rarest but has the highest mortality rate Mainly occurs in immunocompromised patients Primary source of infection: 36% Respiratory 20% Blood 19% Intra-abdominal 13% Urinary Tract 7% Skin / other soft tissue |
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Pathophysiology of Sepsis (progression)
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Localised Inflammatory Response
Pathogens enter blood stream Body compensates (warm phase) Body Decompensates (coldphase) |
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Define Warm stage
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The systemic inflammatory response is established – fluid moving out of circulation to interstitial space causing decrease in BP
Possible increased temperature Body can compensate for inflammatory response by increasing heart rate, heart contractility & vascular resistance to maintain BP |
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Define cold stage
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Scales tip past the body’s ability to compensate for the inflammatory response (BP drops, peripheral circulatory shut down progresses to central circulatory shut down )
Body is no longer able to sustain increased temperature (body has normal temperature or hypothermic) |
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Define Severe sepsis
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Sepsis
Hypoperfusion or elevated lactate Can have warm peripheries & bounding pulse (early stages) |
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Define Septic Shock:
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Sepsis
Persistent hypotension despite adequate fluid resuscitation |
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Treatment of Sepsis/Septic Shock
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Oxygen
Blood culture, Broad Spectrum Antibiotics, Fluid Resuscitation (Normal Saline) If patient remains hypotensive – vasopressor / inotrope therapy Once cultures & sensitivities have returned – Narrow Spectrum Antibiotics Infection source control (e.g. removal of contaminated catheter, wound cleaning) Consider other therapies such as corticosteroids & insulin |
