Sepsis Basics
This is the most common complication of an infection.
What is sepsis?
This is the minimum heart rate parameter required to meet criteria of organ dysfunction.
What is greater than 90 beats per minute?
If a patient's initial lactate level returns at this exact number or higher, a repeat lactate level must be drawn within 6 hours.
What is 2.0 mmol/L (or greater than 2)?
This central nervous system change is a classic, early indicator of sepsis, especially in elderly patients.
What is altered mental status (confusion)?
Persistent hypotension despite adequate fluid resuscitation defines this condition.
What is septic shock?
This is the statistical fraction of hospital deaths that involve a diagnosis of sepsis.
What is 1 in 3?
A patient's temperature must be greater than 38°C (100.4°F) or less than this Celsius threshold to raise concern for infection.
What is 96.8F?
This crucial diagnostic action must always be performed prior to infusing the first dose of broad-spectrum antibiotics.
What is drawing blood cultures? (from 2 separate sites)
This is the number one organ system to fail during severe sepsis, often indicated by a sharp drop in urine output.
What is the renal system (kidney failure)?
When managing septic shock, vasopressors are titrated to maintain this overarching hemodynamical target metric at a minimum of 65 mmHg.
What is mean arterial pressure (MAP)?
This is the most common primary site or source of infection that triggers sepsis.
What is pneumonia (lungs)?
Nurses are best positioned to identify this by comparing a patient's current condition to their usual state.
What is trending changes from baseline? (mentation, VS, UOP etc.)
This is the standard, weight-based fluid resuscitation volume (in mL/kg) mandated for patients presenting with sepsis-induced hypotension or a lactate ≥ 2 mmol/L.
What is 30 cc/kg?
This liver function lab value must rise above 2 mg/dL to be considered a sign of hepatic organ dysfunction in sepsis screening.
What is total bilirubin?
In septic shock, elevated lactate can indicate this despite apparently adequate blood pressure.
What is tissue oxygen delivery/perfusion?
True or False: Sepsis can be caused by viruses, fungi, or parasites, not just bacteria.
True
A serum lactate greater than this value suggests organ dysfunction in sepsis.
What is lactate > 2.0 mmol/L.
This chemical by-product of anaerobic metabolism must be drawn immediately at the start of the bundle to check for hidden tissue hypoperfusion.
What is lactic acid?
A drop in this specific laboratory blood cell count below 100,000/μL serves as an official hematological marker for sepsis-induced organ failure.
What are platelets?
A patient with urosepsis has hypotension and oliguria. The low urine output suggests dysfunction of this organ.
What are the kidneys?
For every hour that passes without broad-spectrum antibiotic administration, a septic patient's risk of mortality increases by this percent.
What is 8%?
What are some examples of non-infectious triggers for inflammatory host response?
What is pancreatitis (due to autodigestion of tissue), trauma, burns (systemic inflammatory cascade and fluid shift)
The provider orders Vancomycin and cefepime for a patient with suspected sepsis. Which antibiotic do you administer first?
What is Cefepime?
To optimize the efficacy of time-dependent killing, guidelines recommend administering maintenance doses of beta-lactam antibiotics via this method rather than standard bolus injections.
What is prolonged (continuous) infusion?
A septic patient has an obstructed infected urinary system. Antibiotics alone may not be sufficient; this intervention is needed to address the underlying problem.
What is source control/decompression?