Week 2 Misc

Question 1

When is Sepsis diagnosed?

Answer 1

• Only confimred when the evidence becomes available, normally on discharge.

Question 2

After what NEWS2 score should sepsis be considered?

Answer 2

• 5+

Question 3

What is the average increase in mortality rate for every hour antibiotics are delayed?

Answer 3

7.6%

Question 4

Define “DIC”

Answer 4

Disseminated intravascular coagulation, Where the activation of the coagulation system causes thrombi to build in the small blood vessles.

Question 5

Define “Sepsis”.

Answer 5

Life threatening organ dysfunction caused by a disregulated host response to infection.

Question 6

What are the 3 key considerations when assessing and treating septic patients?

Answer 6

• Increased index of suspicsion
• Early recognition
• Rapid transport to ED.

Question 7

When assessing a Pt who has been under oncology for the last 12 month, which screening tool should be used?

Answer 7

UKCONS

Question 8

What are the risk factors that may indicate new borns becoming Septic?

Answer 8

• History of fever during labour
• History of previous children acquiring sepsis
• History of ruptured membranes during labour

Question 9

Which groups are at High risk of sepsis?

Answer 9

• <1 or >75
• Immuno-compromised
• Recent surgery
• Breech of skin integrity
• IV Drug users
• Indwelling lines (Catheters ect)
• Pregnant women

Question 10

What is the mortality rate in neutropenic septic adults?

Answer 10

21%

Question 11

How long after Chemotherapy is a patient at risk of neutropenic sepsis?

Answer 11

Most susceptible for up to 10 days
6-8 weeks following treatment

Question 12

What are the main red flags/ recognition features for neutropenic sepsis?

Answer 12

• Tachypneoia
• Tachycardia
• Hypotension
• > 37.5
• Pleuritic chest pain
• Shivering
• Catheter site infections

Question 13

Define “Drowning”.

Answer 13

The process resulting in primary respiratory impairment from submersion or immersion in a liquid medium

Question 14

Define “Immersion”.

Answer 14

Refers to the patient being covered in a liquid mediu, likely to cause hypothermia and cardiovascular collapse.

Question 15

Define “Submersion”.

Answer 15

When the entire body including airway, under the liquid medium, with asphyxia and hypoxia being the main concerns.

Question 16

Why do people take a breath when submerged in water?

Answer 16

When someone holds their breath, their CO2 inceases, body drives to need take a breath.

Question 17

What is the purpose of larygospasam?

Answer 17

To prevent water entering the lungs

Question 18

What damage occurs to the lungs following a drowning?

Answer 18

• increased permeability of the alveolr-capillary membranes
• Increased movement of fluid, plasma and electrolytes
• Reduced gaseous exchange
• Development of pulmonary odeama

Question 19

What is the best position to keep a PT in when extricating post drowning?

Answer 19

• Laid flat too prevent postural drops.

Question 20

Define “hypercarbic”.

Answer 20

• Someone with a high PaCO2.

Question 21

What would be the next step if a PT was found with AF and asymptomatic?

Answer 21

• Referral to GP if otherwise well

Question 22

At what diastolic pressure should a pregnant PT be considered as at risk for pre-eclampsia?

Answer 22

90+

Question 23

If someone is hypertensive but asymptomatic where do they need to be referred?

Answer 23

• Own GP within 7 days, same day GP if 180/120

Question 24

When a PT presents with a Blood glucose of between 9-17, where do they need to be referred if not transporting to hospital?

Answer 24

• Own GP within 3 days