Fluid Management
Preferred initial fluid for patients with maternal sepsis
What is lactated ringers
HR >120 or <60
RR >24 or <12
Temp >101.0 or <96.8
WBC >15K or < 4K or >10% bandemia
The most important medication to give to patients with suspected sepsis
What are broad-spectrum antibiotics?
A lab value that indicates tissue hypoxia
What is lactic acid or lactate?
Alcohol based swab
What do you use to clean the blood culture bottle tops?
IVF bolus parameters for the maternal patient
What is 30ml/Kg based on ideal body weight?
Three risk factors for maternal sepsis
What are cesarean delivery, genital tract infection, pneumonia, pregnancy loss or abortion, urinary tract infection, post-partum hemorrhage, endometritis, chorioamnionitis, mastitis
Lab and vital sign frequency for patients with suspected sepsis
What is hourly x4 or until patient improves?
A lactate (lactic acid) level greater than this number (mmol/L) suggests tissue hypoperfusion and possible septic shock in a non-laboring pregnant woman
What is 2 mmol/L?
Used for venipuncture site preparation
What is Chloraprep?
The time frame to complete the IVF bolus from the provider's order
What is three hours?
Three symptoms of sepsis, excluding vital sign changes
What are confusion, extreme fatigue, shortness of breath, cold/clammy/pale hands or feet, feeling extremely unwell, decreased amount of urine, severe pain, and shivering?
Time frame to start antibiotics from the provider's order
What is 1 hour or less?
Four lab studies to consider for patients with suspected sepsis
What are cultures of suspected sites, CBC, blood cultures, Coags, CMP, lactic acid, ABG,
Should not be covered with the patient label
What is the bar code label on the bottles
Intervention that facilitates the concurrent administration of antibiotics and rapid fluid bolusing
What is placement of two large bore IV catheters?
Skin mottling and cold extremities in a septic patient indicate this critical issue
What is hypoperfusion?
Four components of maternal sepsis treatment
What are timely antibiotics, fluid resuscitation, source identification/control, vasopressors, labs/diagnostic tools, and supportive care for affected systems?
Maybe positive or negative in patients with sepsis
What are blood cultures?
May lead to false negative results
Avoid aggressive, unmonitored fluid administration
How do you manage IV fluids after resolving shock and hypoperfusion?
Three indicators of end-organ damage
What are confusion, MAP <65 or SBP <90, SpO2 <94%, Creatinine >0.3mg/dl from baseline or urine output <0.5ml/kg/hour for two hours, platelet count < 150, INR >1.5 or PTT >45 seconds, Total bilirubin >1.2 mg/dl
An indicator of acute hypoxemic respiratory failure on oxygen
What is the P/F Ratio?
PaO2/FiO2
The most common bacterial pathogen associated with maternal sepsis
What is e coli?
Minimum amount of blood to collect for each bottle
What is 8-10 ml?