Sepsis

Question 1

What is sepsis?

Answer 1

Systemic inflammatory response to infection
Life threatening organ dysfunction caused bacteraemia and dysregulated host response to infection
Medical emergency

Question 2

Clinical presentation

Answer 2

Fever, Rigors, Sweats
Tachycardia
Tachypnoea
Hypotension
Pain, guarding
PR blood
N&V
Diarrhoea
Constipation

Question 3

Diagnosing sepsis

Answer 3

SIRS Criteria 
If you have 2 or more SIRS + infection then you have sepsis
- temperature >38 <36
- heart rate >90 
- resp rate >20
- WCC >12,000 or <4,000

Question 4

Investigations

Answer 4

Bloods - WCC, Platelets, CRP
Cultures - blood, stool, urine
Microscopy - stool, urine, sputum
Serology
PCR

Question 5

Management

Answer 5

Give 3, take 3

• give high flow O2
• give IV fluids
• give IV antibiotics
• take blood cultures
• take FBC and lactate (measure of tissue death)
• take hourly urine output

Question 6

Antibiotics (emperic formula)

Answer 6

Amoxicillin - strep, enterococcus
Metronidazole - anaerobes
Gentamicin - coliforms
Administer for 10-14 days

Question 7

Septic shock

Answer 7

Sepsis induced hypotension

Hallmarks of sepsis + at lease 1 acute organ dysfunction