Sepsis

• Infection in the blood
• evolving process of sepsis may result in septic shock if not recognized and treated early
• Immunosuppression is the biggest risk for septic shock
• Systemic Inflammatory Response Syndrome (SIRS) is the widespread inflammatory response throughout the body triggered by insults like infection
• Sepsis manifests

  • temperature > 38.3 or < 36
  • tachycardia, tachypnea
  • WBC count of > 12 or < 4
  • warm, flushed skin, bounding pulses, increased RR, agitation
• As sepsis progress

  • tissues decreases perfusion
  • compensation begins to fail
  • sx of organ dysfunction
  • BP wont respond to fluid
• medical treatment are

  • fluid replacement
  • broad spectrum antibiotics
• Infection-> SIRS-> vasodilation occurs and > vascular permeability-> impairs O2 delivery-> MODS-> hemodynamic instability
• primary cause of sepsis is the decrease in SVR
• Early stage of sepsis

  • BP WNL
  • Responsive to fluids
  • hyperthermia -> warm, flushed skin and bounding pulses
  • increased RR
• Severe stage of sepsis

  • body cant compensate
  • BP doesnt respond to fluids
  • signs of organ damage are evident
• Septic shock

  • BP drops
  • non responsive to fluid resuscitation
  • normal HR
  • > RR
  • skin cool, pale, mottled
  • MODS progressing to death
• Golden hour: antibiotics are initiated within 1st hour of suspected sepsis
• blood culture-> take sample of blood stream to know effective antibiotic-> takes 3 days-> give broad spectrum antibiotics in the meantime
• Nursing management:

  • perform procedures aseptically
  • monitor sxs of infection
  • prevent infection