Two Generals
Temperature >101 F and Respirations > 20
What are two of the SIRS criteria?
TACHYCARDIA is a SIRS criteria if heart rate is greater than
What is >90?
Poor Perfusion
What is the main problem in sepsis?
2 early interventions to treat severe sepsis with hypotension in the first 3 hours of sepsis presentation.
What is Fluids and Broad Spectrum Antibiotics.
One of the most common errors made during resuscitation of the patient with severe sepsis is inadequate replacement of fluid. N/S 0.9% or Lactated Ringers are both acceptable. Antibiotics should be given within first 30-60 minutes.
The window of time you have to send the repeat lactate when your initial result is >2.
What is within 6 hours after the initial lactate results?
Decreased mental functioning.
Post-traumatic stress disorder (PTSD).
Amputations.
Insomnia.
What are possible complications after surviving sepsis?
250,000
What is how many people in the U.S. die each year because of sepsis?
Every two minutes, a life is lost to sepsis in the U.S., totaling over a quarter million people every year.
This should be done if the provider orders the initial lactate, the result is > 2.8, and no repeat lactate has been drawn.
What is notify the physician and request an order for repeat lactate?
If initial fluid resuscitation efforts are not enough and the patient remains hypotensive, the following intervention may be necessary within 6 hours of sepsis presentation
What is vasopressor therapy?
ALWAYS collect these PRIOR to antibiotics
What are blood cultures?
UTI, Pneumonia, or an implantable device infection
What are examples of suspected or confirmed infections?
Lactate is considered organ dysfunction if
What is >2?
Sepsis + organ dysfunction + volume-resistant hypotension (i.e. MAP < 65 after 30mL/kg or 2–4 liter bolus).
What is a Septic Shock?
A patient has presented with sepsis from an infected PICC line. They are febrile, and hypotensive. The MD has started broad spectrum antibiotics. What IV fluid you would expect to see given to this patient within 6 hours of sepsis presentation?
What is Normal Saline Solution/LR?
Suspected or confirmed infection, systemic inflammatory reaction, organ failure and hypotension that doesn't respond to bolus and/or initial lactate >4
What is septic shock?
Heart rate > 90 and Systolic Blood Pressure < 90
What are two of the SIRS criteria?
Initial lactate >4
What is an indication of septic shock requiring fluid management?
Most commonly occuring source of infection
What is respiratory illness?
I am the time frame allotted to obtain blood cultures, start broad spectrum antibiotics and draw a lactate
What is the 3 hour window?
A cut on your finger.
A urinary tract infection (UTI).
A mosquito bite.
A tattoo.
In addition to lactate, repeat lactate, blood cultures and IV antibiotics, I am required for all patients with septic shock
What is 30 ml/kg fluid bolus?
Your patient is being treated for community acquired pneumonia. You notice new onset lethargy and confusion at 12:15. You observe the HR > 90 @ 11:00, temp 103 @ 12:00. What is the time of presentation for sepsis.
What is 12:15?
Name 2 types of patients at risk for getting sepsis
What is Older adults, Pregnant women, Children younger than 1, People who have chronic conditions, such as diabetes, kidney or lung disease, or cancer, People who have weakened immune systems.
Lab also drawn with blood cultures in the 3 hour window
What is a Lactate?