Sepsis

• What type of infection accounts for the majority of sepsis presentations?

  Bacteria
• What are the most common sources of infection leading to sepsis?

  Pneumonia

  Intra-abdo infections

  UTI

  Skin and soft tissue infections

  Bacteremia
• What is the definition of sepsis?

  Life-threatening organ dysfunction caused by a dysregulated host response to infection
• What is the definition of septic shock?

  A more severe form of sepsis -> which circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
• What does a qSOFA score take into account?

  Resp rate >22

  Altered mentation

  Systolic BP <100
• When is a full SOFA score used?

  Within an ICU setting
• What does the SOFA score grade?

  Abnormalities by organ system and accounts for clinical interventions
• A SOFA score of 2 or more reflects an overall mortality risk of approximately 10% in a general hospital population with suspected infection.
• When is a qSOFA done?

  Patients outside of ICU with suspected sepsis
• What is included in the red flag criteria for risk stratification recommended by NICE for sepsis?

  Responds only to voice or pain/unresponsive

  Acute confusion

  Systolic BP <90

  HR >130

  Resp rate >25

  Needs O2 to keep >92%

  Skin changes

  Not passed urine in 18 hrs

  Lactate >2

  Recent chemo
• When should sepsis 6 be started?

  If any of the red flags are present
• What is sepsis 6?

  Give oxygen

  Give abx

  Give fluids

  Take blood cultures

  Take lactate

  Take urine output
• How is sepsis treated?

  Cause needs to be identified and treated