Sepsis

Question 1

Define Sepsis.

Answer 1

Life-threatening condition- when body’s response to infection becomes damaging- inflammation- immune system reactions become dysregulated

Question 2

Define septic shock.

Answer 2

Paticularly profound circulatory, cellular, metabolic abnormalities- dangerously low blood pressure

Question 3

What are the effects of Sepsis on the organ systems? (ABCDE)

Answer 3

Airways- if infection in throat/neck

Breathing- tachpnoea, fluids & proteins leaking- lung oedema

Circulation- hypovolaemia (vasodilation), hypotension, tachycardia

Disability- reduced blood flow to BRAIN- confusion, anxiety, drowsiness

Exposure- high temperature

Question 4

What’s the approximate mortality rate for sepsis?

Answer 4

29%

Question 5

Who is at high risk of acquiring sepsis?

Answer 5

• V. young (<1yr)
• Elderly (>75yrs)
• Pregnant, post partum (within 6 weeks)
• Immunocompromised

Question 6

How do we diagnose sepsis?

Answer 6

Trigger early warning score (NEWS2)

Question 7

What is NEWS2?

Answer 7

National Early Warning Score 2:

6 physiological measures:

1. Respiration rate
2. Systolic Blood pressure
3. Oxygen saturation
4. Temperature
5. Conciousness level
6. Pulse rate

Question 8

What does calculating a NEWS2 score allow for?

Answer 8

Indentify patients who need URGENT CLINICAL REVIEW

If SCORE is 5+ THINK SEPSIS

Question 9

What is ‘Red flag sepsis’?

Answer 9

Criteria used to identify patients with any organ dysfunction

Question 10

Name some ‘redflag symptoms’ for sepsis.

Answer 10

• Acute confusion
• Respiratory rate >25 per minute
• Non-blanching rash
• Recent chemo
• HR >130 bpm
• Not passed urine- last 18 hrs

Question 11

What is the sepsis 6 care bundle- which will increase a patients chance of survival if delivered in first hour of sepsis recognition? (BUFALO with 1 F)

Answer 11

B= Take BLOOD CULTURE- identify pathogen

U= Monitor URINE output

F= Give FLUIDS (improve preload to heart)

A= Give ANTIBIOTICS

L= Take HB and LACTATE (high lactate= hypoperfusion)

O= Give OXYGEN (improve content in blood)

Question 12

How is cerebrospinal fluid obtained?

Answer 12

Lumbar puncture (used for diagnostics)