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Sepsis/Septic Shock UNFOLDING Reasoning Case Study Jack Holmes, 72 years old (answered fully)
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\Sepsis/Septic Shock UNFOLDING Reasoning Case
Study Jack Holmes, 72 years old (answered fully)
True or false: There is currently no cure for sepsis - ANSWER True (all care is
supportive)
How is SIRS defined? - ANSWER 2 or more of the following:
Temp >38 (100.4) or < 36 (96.8)
HR >90
RR > 20 or PaCO2 <32
WBC > 12,000 or <4000 or >10% bands
How is sepsis defined? - ANSWER SIRS + documented infection
How is severe sepsis defined? - ANSWER sepsis associated with organ dysfunction,
hypoperfusion and hypotension
How is septic shock defined? - ANSWER Sepsis induced hypotension, despite fluid
resuscitation (requires vasopressors, MAP <65)
What is the hallmark sign of sepsis? - ANSWER Hypotension
what are signs and symptoms of early sepsis? - ANSWER fever, chills, tachycardia,
tachypnea, hyperglycemia, altered mental status, oliguria, hypotension, low CV O2
saturation
What are the signs and symptoms of late sepsis? - ANSWER Lactic acidosis,
pulmonary edema, myocardial depression, hypoglycemia, thrombocytopenia, DIC,
coma
Where is the most common source of infection? - ANSWER Lungs
What is an example of a crystalloid fluid? - ANSWER Normal saline (0.9%)
What is an example of a colloid fluid? - ANSWER 5% albumin solution
Can D5W be used in shock? - ANSWER NO! can increase edema
What does a high lactate level indicate? - ANSWER lack of tissue O2 and anaerobic
metabolism
what is the average amount of fluid needed? - ANSWER 4-6L
What is the goal for MAP? - ANSWER >65 mmHg
what is the goal for UOP? - ANSWER >0.5 ml/kg/hr
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