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    Sepsis and Septic Shock

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    Pak Budi warsono
    Sepsis is defined as a systemic response to infection that can lead to severe sepsis or septic shock. Severe sepsis occurs when there is organ dysfunction or hypotension present due to the infection. Septic shock is defined as hypotension and organ failure due to severe infection. The document outlines signs and symptoms of sepsis, common causative organisms, appropriate diagnostic tests, and initial treatment steps including oxygen therapy, IV fluids, antibiotics, and monitoring for septic shock.

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    Sepsis and Septic Shock

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    Pak Budi warsono
    63 views14 pages
    Sepsis is defined as a systemic response to infection that can lead to severe sepsis or septic shock. Severe sepsis occurs when there is organ dysfunction or hypotension present due to the infection. Septic shock is defined as hypotension and organ failure due to severe infection. The document outlines signs and symptoms of sepsis, common causative organisms, appropriate diagnostic tests, and initial treatment steps including oxygen therapy, IV fluids, antibiotics, and monitoring for septic shock.

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    Sepsis is defined as a systemic response to infection that can lead to severe sepsis or septic shock. Severe sepsis occurs when there is organ dysfunction or hypotension present due to the infection. Septic shock is defined as hypotension and organ failure due to severe infection. The document outlines signs and symptoms of sepsis, common causative organisms, appropriate diagnostic tests, and initial treatment steps including oxygen therapy, IV fluids, antibiotics, and monitoring for septic shock.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    63 views14 pages

    Sepsis and Septic Shock

    Uploaded by

    Pak Budi warsono
    Sepsis is defined as a systemic response to infection that can lead to severe sepsis or septic shock. Severe sepsis occurs when there is organ dysfunction or hypotension present due to the infection. Septic shock is defined as hypotension and organ failure due to severe infection. The document outlines signs and symptoms of sepsis, common causative organisms, appropriate diagnostic tests, and initial treatment steps including oxygen therapy, IV fluids, antibiotics, and monitoring for septic shock.

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    © All Rights Reserved
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    Download as ppt, pdf, or txt
    of 14

    Tim IGD RSSA 2011

    Sepsis is a systemic response to infection.


    Be diagnosed two or more of the following
     Respiratory rate >20 breaths/min or PaCO2
    <4.3 kPa.
     Heart rate >90 beats/min.
     Temperature >38ºC or <36ºC.
     WBC>12,000 cells/mm3, <4000 cells/mm3,
    or >10 percent immature forms.
     Plus suspected or confirmed infection
     Severe sepsis is present when organ
    dysfunction, hypoperfusion (e.g. lactic
    acidosis, oliguria, or an acute alteration in
    mental status) or hypotension (systolic BP
    <90mmHg) .
     Septic shock is broadly defined as the
    development of hypotension and organ failure
    as a result of severe infection.
     Septic shock is a clinical diagnosis,
    confirmed by positive blood cultures in only
    a proportion of cases.
     Specific clinical features:
     • Auscultation may reveal evidence of pneumonia
    or endocarditis.
     • Abdomen - tenderness, peritonitis.
     • Skin - rash, petechiae in meningoccaemia.
     • Skin: cellulitis, evidence of IVDA.
     • CNS: Photophobia and neck stiffness in
    meningitis.
     • Urinary tract symptoms? Loin pain?
     • Lines - Intravascular
     • Trauma
    • Airway: usually secure initially unless reduced
    conscious level.
    • Breathing: tachypnoea is common and an early
    sign.
    Circulation:
     Tachycardia and hypotension .
     In early shock there is peripheral vasodilatation
    and increased cardiac output.
     In advanced septic shock cardiac output falls due
    to hypovolaemia,(+/- myocardial depression) and
    the skin becomes cold, cyanotic and mottled with
    increased capillary refill time.
     If unresponsive to volume resuscitation the patient
    is at high risk of death.
     Disability - GCS, pupils, focal neurological
    signs.
    • Community-acquired sepsis: Coliforms,
    Streptococcus pneumoniae,
     Neisseria meningitidis, Staphylococcus aureus.
    Group A Streptococcus.
    • In hospital patients or recently discharged
    patients MRSA is increasingly encountered as
    are multi-resistant gram negatives.
    • Clostridium difficile may develop up to 8
    weeks after antibiotic.
     In patients with abdominal sepsis, mixed infection
    with coliforms, anaerobes.
     In patients with neutropenia, Pseudomonas
    aeruginosa must be covered.
     Splenectomised patients are at particular risk from
    capsulated organisms (Streptococcus pneumoniae,
    Haemophilus influenzae, Neisseria meningitidis)
    and severe malaria.
     Seek advice from ID or Microbiology if unusual
    freatures – travel history, animal contact, IVDU.
     Blood cultures.
     Chest X-ray
     Urine: dipstick for WCC and nitrites
     Pus, wound swabs
     Sputum
     CSF
     Blood (EDTA or clotted) PCR if meningitis
    suspected
     Stool if diarrhoea
     FBC,CRP
     High concentration oxygen  SpO2 >96%.
     Secure adequate IV access and commence volume
    replacement  Saline 0.9% or colloid
     Take blood cultures x2
     start appropriate IV antibiotics.
     Draw venous blood for FBC, U&Es, glucose, clotting.
     Check arterial blood gases and blood lactate.
     Insert a urinary catheter.
     Observe carefully for fluid overload and be aware of
    the possibility of acute renal failure.
     Remove or drain any obvious source of infection such
    as an abscess or infected IV line.
     Septic shock unresponsive to oxygen
    therapy and initial volume loading has a
    high mortality. Invasive monitoring and
    vasopressor therapy are likely to be
    necessary.
     CALL ICU EARLY.
    Thank You

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