Notes in 01_Sepsis

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Published	02/10/2024	Criteria of a {{c2::Systemic Inflammatory Response Syndrome (SIRS)}} is {{c1::Temp. >38°C or <36°C}} {{c1::HR >90}} {{c1::RR >20}} or {{c1…
Published	02/10/2024	{{c1::Sepsis}} is defined as {{c2::life-threatening organ dysfunction caused by dysregulated host response to infection (10% mortality risk)}}
Published	02/10/2024	Organ dysfunction in Sepsis can be identified as an {{c1::acute change in total SOFA score >2 points consequent to the infection}}
Published	02/10/2024	Patients with suspected infection who are likely to have a prolonged ICU stay or die in the hospital can be promptly identified with a {{c1::qSOFA}} s…
Published	02/10/2024	Criteria of qSOFA: {{c1::Hypotension (Systolic BP <100mmHg)}} {{c1::Altered Mental State (GCS — Confused)}} {{c1::Tachypnea RR >22/min}}
Published	02/10/2024	qSOFA Score of {{c1::≥2}} Critera suggests a Greater Risk of a Poor Outcome, not used to diagnose infection
Published	02/10/2024	{{c1::Septic shock}} can be identified with a clinical construct of {{c2::sepsis with persisting hypotension with patients having these criteria…
Published	02/10/2024	In sepsis, blood lactate rises due to {{c1::hypoperfusion}} of tissues that starves the tissues of oxygen causing them to switch to {{c2::an…
Published	02/10/2024	Function of {{c2::Pro}}-inflammatory mediators in Sepsis {{c1::Promote endothelial cell — leukocyte adhesion}} {{c1::Release of arachidonic acid metab…
Published	02/10/2024	Function of {{c2::Anti}}-inflammatory mediators {{c1::Inhibit TNF alpha}} {{c1::Augment acute phase reaction}} {{c1::Inhibit activation of coagulati…
Published	02/10/2024	If compensatory anti-inflammatory mediators win over the pro-inflammatory ones; we see:{{c1::Septic shock}} with {{c1::multiorgan failure}} and {{c1::…
Published	02/10/2024	If pro-inflammatory mediators win over the compensatory anti-inflammatory ones; we see:{{c1::Immunoparalysis}} with {{c1::uncontrolled infection}} and…
Published	02/10/2024	Risk factors of Sepsis {{c1::Very young or old patients (under 1 or over 75 years)}} {{c1::Chronic conditions such as COPD and diabetes}} {{c1::Chemot…
Published	02/10/2024	General features of Sepsis {{c1::Temperature (Fever >38 C) or (Hypothermia <36 C)}} {{c1::Heart rate (Tachycardia >90 b/m)}} {{c1::Respirator…
Published	02/10/2024	Inflammatory variables in Sepsis {{c1::Leucocytosis (WCC > 12,000/ml)}} {{c1::Leucopenia (WCC < 4,000/ml)}} {{c1::Normal WCC with greater than 1…
Published	02/10/2024	Haemodynamic variables in Sepsis {{c1::Blood pressure (systolic <90mmHg or MAP <70mmHg)}} {{c1::Mixed venous oxygen saturation (SvO2 >70%)}}
Published	02/10/2024	Organ dysfunction variables in Sepsis {{c1::Arterial hypoxaemia (PaO2/FiO2 < 50mmHg)}} {{c1::Oliguria (<0.5ml/kg/h)}} {{c1::High Creatinine}} {{…
Published	02/10/2024	Tissue perfusion variables in sepsis {{c1::High lactate}} {{c1::Skin mottling and reduced capillary perfusion}}
Published	02/10/2024	Signs on Examination of Sepsis {{c1::Signs of potential sources such as cellulitis, discharge from a wound, cough or dysuria}} {{c1::Non-blanching ras…
Published	02/10/2024	{{c1::High respiratory rate (tachypnoea)}} is often the first sign of sepsis
Published	02/10/2024	Arrange blood tests for patients with suspected sepsis: {{c1::FBC}} to assess cell count including white cells and neutrophils {{c1::U&Es}} t…
Published	02/10/2024	Additional investigations can be helpful in locating the source of the infection in Sepsis: {{c1::Urine dipstick and culture}} {{c1::Chest xray}} {{c1…
Published	02/10/2024	Scores to assess Sepsis are {{c1::qSOFA}} and {{c1::SOFA}}
Published	02/10/2024	Score to assess Pneumonia severity is {{c1::CURB 65}}
Published	02/10/2024	The most important marker to check in Sepsis is{{c1::Lactate — high lactate indicates generalised hypoperfusion, severe sepsis, poor prognosis}}
Published	02/10/2024	Approach to Sepsis and Sepsis Shock (Diagram){{c1::}}
Published	02/10/2024	Patients should be assessed and treatment initiated within 1 hour of presenting with suspected sepsis. This involves performing the {{c1::se…
Published	02/10/2024	The Three Tests of Sepsis Six are[1] {{c1::Blood lactate level (High — marker of generalised hypoperfusion, severe sepsis, poor prognosis)}}[2] {{c1::…
Published	02/10/2024	The Three Treatments of Sepsis Six are[1] {{c1::Oxygen to maintain oxygen saturations 94-98% (or 88-92% in COPD)}}[2] {{c1::Empirical broad spect…
Published	02/10/2024	Sepsis SixThe Three Tests[1] {{c1::Blood lactate level (High — marker of generalised hypoperfusion, severe sepsis, poor prognosis)}}[2] {{c1::Blo…
Published	02/10/2024	Type {{c2::A}} Lactate indicates {{c1::Hypoperfusion}}
Published	02/10/2024	Type {{c2::B}} Lactate indicates {{c1::Mitochondrial toxins, Alcohol, Malignancy, Metabolism errors}}
Published	02/10/2024	Treatment of Septic Shock {{c1::IV fluids to improve the blood pressure and the tissue perfusion.}} {{c1::Vasopressors}}{{c1::Inotropes (such as&…
Published	02/10/2024	When to consider HDU referral in Sepsis {{c1::Low BP responsive to fluids}} {{c1::Lactate >2 despite fluid resuscitation}} {{c1::Elevated creatinin…
Published	02/10/2024	When to consider ICU referral in Sepsis {{c1::Septic shock}} {{c1::Multi-organ failure}} {{c1::Requires sedation, intubation and ventilation}}
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