SEPSIS & SIRS

DEFINITIONS
Bacteraemia | viable bacteria in the blood.
Sepsis | life-threatening organ dysfunction caused by dysregulated host
response to infection.
Septic shock | subset of sepsis—profound circulatory, cellular, and metabolic
abnormalities are associated with increased risk of mortality.

SIRS vs Sepsis Most common sources

of infection leading to
Systemic Inflammatory Response Syndrome (SIRS) is a bodily response causing sepsis are respiratory
>2 of the following. tract infections and
urinary tract infections.
• Temp. < 36 C OR > 38.3 C • BG > 7.7 mmol/L
• HR > 90 bpm • WBC < 4 OR > 12
RISK FACTORS
• RR > 20 bpm
• Advanced age
• Immunosuppressed
• Recent surgery/
hospitalization

ANTIBIOTICS
SEPSIS 6 in 1 Hour
Respiratory Tract
Give Take
• Oxygen (94-98% SpO2 or 88-92% COPD) • Blood cultures • Penicillin V (calvipen)
• Amoxicillin
• IV Antibiotics • Lactate and FBC
• Clarithromycin
• Fluids (500 mL bolus; 30mL/kg max) in 15 min. • Urine output & culture • Doxycycline
!
RED FLAGS Urinary Tract

Sepsis progresses to septic shock when… • Trimethoprim

• Nitrofurintoin
• SBP < 90 mmHg • AVPU response of V or P • Cephalexin
• HR > 120 bpm • Supplemental O2 for > 92% • Fosfomycin
• RR > 25 bpm • Lactate > 2 mmol/L
Cellulitis
If hypotension unresponsive to fluids (MAP < 65 or SBP <90)
• Trimethoprim
• Doxycycline
• Flucloxacillin
Fluid replace + vasopressors. • Lymecycline

Vasopressors
1) Norepinephrine (1-10 mcg/min) Fluid Overload:
2) Unresponsive? Add vasopressin (0.04 units/min). S&S of jugular venous
distention, chest
q-SOFA crepitations, &
Bedside score for mortality risk for patients with organs failure & sepsis. decreased pulse O2
Score >2 is high indicator of poor outcome. readings. Stop all IV
1) Altered mental 2) RR >22 bpm 3) SPB < 100 mmHg fluids until no longer
status overloaded.