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Flashcards in Severe Infections and Sepsis Deck (10)
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1

What is SIRS?

Systemic Inflammatory Response Syndrome

An inflammatory response to infection or a non-infectious insult that affects the whole body. 

2

Define sepsis

What is severe sepsis?

When the body's response to infection causes injury to its own tissues. 

Severe sepsis = organ dysfunction

SIRS + infection = sepsis

3

What is septic shock?

Sepsis + hypotension despite fluid resuscitation + perfusion abnormalities e.g. lactic acidosis, reduced UO and GCS

4

Describe the pathogenesis of sepsis

Begins with stimulation of the innate/adaptive immune systems, which leads to the release of pro-inflammatory cytokines. 

  • = fever symptoms, vasodilation, increased capillary permeability, increased WCC and activity, decreased myocardial function. If severe, can lead to:
    • Hypovolaemia, hypoxia and hypotension →
    • Hypoperfusion of tissues →
    • Anaerobic respiration and acidosis →
    • End organ damage and multi-organ failure. 

5

Which clinical features define SIRS?

> 1 of:

  • Temp <36 or >38
  • HR >90bpm
  • Resps >20 or pCO2 < 32
  • WCC high or low
  • CBG > 7.7mmol/L unless DM present

6

Which red flag symptoms could indicate severe sepsis?

  • Hypotension (<90mmHg systolic)
  • HR >130bpm
  • RR >25/min
  • O2 sats <91%
  • Reduced GCS
  • Lactate >2mmol/L
  • Purpuric rash 

7

What indicators on the QSOFA score indicate sepsis?

RR >22

Reduced conscious level

Systolic BP <100mmHg

8

Which infections could lead to severe sepsis?

  • CNS: meningitis, encephalitis
  • LRTI
  • Infective endocarditis
  • Infective gastroenteritis
  • UTI (esp. pyelonephritis)
  • SSTI (cellulitis and necrotising fasciitis)
  • Osteomyelitis and septic arthritis 

9

Describe the Sepsis 6

Blood cultures

Urine output

Fluid resuscitation

Antibiotics

Lactate

High flow Oxygen 

10

What tool should be used to screen for sepsis?

Trust sepsis pathway