SEPSIS
A LIFE THREATENING SYNDROME IN REPSONSE TO INFECTION.
WHAT IS SEPSIS?
CONDITIONS NECESSITATING PROMPT ANTICOAGULANT ACTIVITY (EVOLVING STROKE, PE, OR MASSIVE DVT).
WHAT IS HEPARIN?
HTN AND CAD ARE THE PRIMARY RISKS.
WHAT ARE HF RISKS?
PATIENT FOUND DOWN, GASPING AND NO PULSE FELT.
WHAT WARRANTS CPR?
INFECTION SUSPECTED; HR >90, SBP<100MM Hg, TACHYPNEA (RR >22/MIN), INCREASED C-REACTIVE PROTEIN, INCREASE WBC
WHAT IS DIAGNOSTIC CRITERIA FOR SEPSIS?
CALCULATED USING PATIENTS WEIGHT KG
WHAT IS INITITAL BOLUS?
DYSPNEA, FATIGUE, S3 HEART SOUND, PULMONARY CONGESTION, FROTHY SPUTUM
WHAT ARE CLINICAL MANIFESTATIONS OF LEFT-HF?
THE TEAM'S PRIMARY GOAL IS TO INTERVENE WHEN A PATIENT BEGINS TO DECLINE, TO PREVENT FURTHER MEDICAL EMERGENCY FROM OCCURING.
WHAT IS THE RAPID RESPONSE TEAM?
DRAW LACTATE, OBTAIN BLOOD CULTURES, ADMINISTER BROAD SPECTRUM ANTIBIOTICS.
WHAT IS THE 3 HOUR BUNDLE?
LEVEL OF 60 TO 80 SECONDS DURING TREATMENT.
WHAT IS THE TARGET aPTT LEVEL?
BNP > 400PG/ML
WHAT INDICATES HF?
PATIENT IS HAVING A BLOOD TRANSFUSION, SHE BEGINS TO EXPERIENCE SHORTNESS OF BREATH, SWELLING OF THE FACE AND ITCHING.
WHAT IS CALL A RAPID RESPONSE?
LACTATE 2.1-3.9, ADMINISTER IV FLUIDS AT 30ML/KG, REPEAT LACTATE.
WHAT IS SEVERE SEPSIS AND TREATMENT?
PROTAMINE; BINDS WITH HEPARIN AND FORMS A HEPARIN-PROTAMINE COMPLEX THAT HAS NO ANTICOAGULANT PROPERTIES.
WHAT IS HEPARIN'S REVERSAL AGENT?
WHAT ARE ACE INHIBITORS
PATIENT IS PLANNING TO CHANGE HIS CODE STATUS TO DNR. WHILE WAITING FOR PROVIDER PATIENT IS FOUND UNRESPONSIVE AND PULSELESS, WHAT IS THE NEXT STEP?
WHAT IS BEGIN CPR?
LACTATE 4.8, BP 80/50 (MAP<65), COOL AND MOTTLED SKIN, RESPIRATORY FAILURE.
WHAT ARE CLINICAL PRESENTATIONS OF SEPTIC SHOCK?
STOP HEPARIN DRIP IF PLATELET COUNT IS LESS THAN 100,000/mm.
WHAT IS HEPARIN-INDUCED THROMBOCYTOPENIA?
TACHYPNEA, PERSISTENT COUGH, ORTHOPNEA
WHAT IS PULMONARY EDEMA?