What is the definition/spectrum of sepsis?

This will be drilled into your head during your critical care/ICU month. This is important to know because mortality associated with severe sepsis is about 30-50%, and rises to 50-60% for septic shock.

Sepsis Severe sepsis Septic shock
2 SIRS* 2 SIRS* 2 SIRS*
+ source + source + source
+1 of: organ dysfxn

-INR >1.5

-plts 2.0

-Cr. >2.0

-lactate >2.0

-SBP <90

+ organ dysfxn
+ not fluid responsive, SBP

SIRS criteria:
-temperature below 96.8 F or above 100.4 F
-HR >90
-RR>20 or PaCO2 <32 mmHg
-WBC below 4,000, above 12,000, or 10% bands

Some pearls about sepsis:
-always make sure to get the blood cultures BEFORE giving antibiotics
-trend lactate…a lactate above 4 is associated with increased mortality
-aim for 20-30 cc/kg fluid resuscitation
-make sure to establish a central catheter

For more information, check out the Surviving Sepsis Campaign, an international collaborative to decrease mortality from sepsis. While it’s probably way too granular for you, you can at least note their guidelines on how to manage sepsis.

But sometimes, you learn best through games. For fun, play Septris!

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