General Sepsis
What does SIRS stand for?
Systemic Inflammatory Response System
Defense response to a stressor
What are some steps that occur in the first three hour bundle?
STAT labs (lactate, cultures), ABX, IVF, IV access
What month and day is Sepsis awareness?
September 13th
What is number one prevention against infection?
Hand Hygiene!
What are two examples of SIRS criteria?
Temp <36 >38
RR <20 or PCO2 <32mmHg
HR >90
WBC >12 or <4
>10% Bands
What needs to happen within the first hour after IVF administration to prevent further deterioration?
Repeat BP x2 within one hour of IVF bolus completion
Each year, approximately how many people in the US die because of sepsis?
270,000
Preventative measures against sepsis?
Vaccinations, wound care, treat infections, prevention for immunocompromise.
What type of ABX are initiated with sepsis?
Broad Spectrum ABX
True or False: Blood cultures should be drawn prior to starting ABX?
True
Where does sepsis or the infection causing sepsis start in nearly 87% of cases?
Outside the hospital/Community
Who is at risk for sepsis?
Elderly, infants, weakened immune systems, recent injuries/surgeries, chronic conditions, pregnancy/post-partum
In the hospital: lines and devices
According to CMS, organ dysfuntion (hypoperfusion) in sepsis is defined as:
Systolic BP <90 MAP <65, New O2 needs (ventilation), Creatinine > 2 or Urine output <0.5/ml/kg/hr for x2 hrs, total bilirubin >2 mg/dL, platelet count <100,000, INR >1.5 or aPTT >60 sec, lactate >2 mmol/L
What interventions should be completed within the six-hour sepsis bundle?
Persistent hypotension- more IVF
Re-check lactate if > or = 2
Vasopressors for persistent SBP > 90 after fluid repletion
Which patient population does sepsis affect for about 5.7 million cases each year?
Maternal Patients
Resources including information to get ahead of sepsis?
Leadership
Policy STAT
CDC
Sepsis Alliance
Joint commission
CMS
Department of Health
Identify Severe Sepsis vs. Septic Shock.
Severe sepsis is lactate > 2, SIRS criteria x2, suspected infection, hypoperfusion
Septic shock is lactate > 4, persistent hypotension despite fluid bolus
True or False: A conditional lactate needs to be drawn if > 2
True
How many people in the U.S. develop sepsis each year?
1.7 million
Rory's Regulations