Assessment & Recognition
A patient has a suspected infection, new confusion, tachycardia, tachypnea, and worsening oxygenation. What should you be thinking?
What is possible sepsis with organ dysfunction?
Target mean arterial pressure (MAP) in septic shock?
What is MAP >/= 65 mmHg?
This test is used to assess for abnormal tissue perfusion in patients with suspected sepsis.
What is serum lactate?
The condition occurs when sepsis progresses to persistent circulatory failure requiring vasopressor support despite adequate fluid resuscitation.
What is septic shock?
This shock state may initially present with warm, flushed skin due to peripheral vasodilation.
What is early septic shock (warm shock)?
This is often the first sign of deterioration in a septic patient.
What is altered mental status?
This vital sign often increases early in sepsis?
What is heart rate?
These should generally be obtained before antimicrobial therapy when doing so does not cause a significant delay in antimicrobial therapy.
What are blood cultures?
A septic patient has BP 74/44, increasing confusion, rising lactate, and minimal urine output. Is this a "watch and wait" situation.
What is absolutely not?
This body system is most commonly the source of sepsis in hospitalized patients.
A serum lactate greater than this value is considered elevated and concerning for tissue hypoperfusion?
What is > 2 mmol/L?
Cool clammy skin, delayed capillary refill, and low urine output suggest poor tissue _______.
What is perfusion?
A patient with suspected sepsis and hypotension needs rapid evaluation and appropriate resuscitation. Name one major component of initial management.
What is 30ml/kg of NS or LR IV?
Patient: BP 78/46, HR 132, Lactate 5.1, and Urine Output 5ml/hr. What should the team be concerned about?
What is progression to septic shock with worsening tissue hypoperfusion?
Name three groups at highest risk for developing sepsis.
What are: older adults, immunocompromised patients, infants, patients with chronic diseases, recent surgical patients?
True or False: A patient must have a very high fever before you should suspect sepsis.
What is false?
A patient's lactate increase from 3.8 to 5.1 while blood pressure falls and urine output decreases. What does this tell you?
What is worsening perfusion and clinical deterioration?
A septic patient remains hypotensive despite appropriate initial fluid resuscitation. What type of medication may be required?
What are vasopressors?
The patient's blood pressure remains dangerously low after initial resuscitation. What should happen next?
What is initiating vasopressors?
What is sterile dressing change, daily CHG bathing, maintaining a dry, intact, and clean dressing (no reinforcement)?
Hypoperfusion and hypotension
What are late signs in sepsis?
Double Jeopardy
Your patient is becoming increasingly confused and hypotensive. The nurse says: "The provider hasn't come to the bedside yet, so we'll wait."Name two things the team can do immediately while escalating care.What is notify Rapid Response Team and obtain cultures/lactate?
After fluids are given, ongoing assessment of this determines response to resuscitation.
What is perfusion/hemodynamic status?
Name four signs that indicate worsening organ dysfunction in septic shock.
Altered mental status, Oliguria/decreased urine output, elevated lactate, hypotension, respiratory failure, increasing creatinine, mottled skin
Name six organs commonly affected by sepsis related organ dysfunction.
What are: brain, lungs, heart, kidneys, liver, and hematologic system/coagulation?