Risk factors
What is the first 'R' of sepsis management in the community
Recognise
True or False: Maternal temperature of 38.8°C is an amber flag for sepsis
False
Sepsis Amber flag states
"Less than 36°C or greater than 39°C".
What is a neurological sign of sepsis?
Altered mental state
3 hours
True or False: Being Immunosuppressed is a risk factor for sepsis
True
What fetal finding might indicate maternal sepsis?
Non-reassuring CRG/fetal tachycardia greater than 160 bpm.
What pregancy condition becomes an amber flag if present for > 24 hours?
Prolonged Rupture of Membranes
When are antibiotics indicated and which antibiotic is recommended?
If one of more amber flags or one red flag.
IV or IM ceftriaxone
Name an obstetric medical procedure that could increase sepsis risk.
perineal repair; or termination of pregnancy; or c/s
True or False.
A lack of a temperature rules out sepsis
False.
A person may still have sepsis despite having a normal temperature
What would you do if your client had a HR of 116 bpm and was 3 days post c/s?
Complete physical exam and history.
Low threshold for referral to obstetrics as recent invasive procedure
What is your management priority if you diagnose a sepsis Red Flag in a primary birthing unit?
Consult with obstetrics to plan emergency transfer to hospital.
What bacterial infection aquired during childbirth could cause maternal sepsis?
Group A Strep
Name an abnormal clinical finding, more common in the postnatal period, that could indicate sepsis
Malodorous vaginal discharge
When would you give IV fluids during suspected sepsis and what would you give?
If a person was hypotensive OR
they had ticked more than one amber flag or a single red flag.
500ml 0.9% saline repeated if clinically indicated up to a maximum of 2000 mL
Which respiratory treatment is part of the sepsis 6?
Giving oxygen if SpO2 ≤ 92%, target saturation ≥ 94%
Would lupus during pregnancy increase a persons sepsis risk?
Yes, this condition causes a person to be immunosuppressed and at greater risk of sepsis.
Which two 'red flags' indicate worsening of respiratory symptoms
A new oxygen requirement and a RR > 25 breaths per minute or more.
Blood cultures are an urgent investigation but do they diagnose sepsis?
No, blood cultures can test negative in sepsis. Use vital signs & other lab tests e.g. WBC as well.
In postnatal sepsis what might cause an infection but also need to be removed as part of treatment?
Evacuation of retained products