Sepsis Criteria
● Temperature >100.4ºF or <96.8ºF
● Pulse >90bpm
● Respirations >20/min
○ Count for at least 30 seconds
Organ Dysfunction
● MAP <65mmHg
● SBP <90mmHg
● SBP decrease of 40mmHg from baseline
● Indicates severe sepsis
Comorbidities
● COPD worst with sepsis
● End-stage renal disease
● Sepsis becomes more morbid with pre-existing conditions
Antibiotics
● Give for sepsis even if patient is already taking antibiotics
○ Most people are non-compliant
○ If showing sepsis symptoms, it means patient is not using their antibiotics
○ If sepsis symptoms, follow protocol
● Culture sensitivity decreases after antibiotic administration
○ Blood cultures always before antibiotics
● Mortality increases by 10% for each hour without antibiotics
● Ceftriaxone safe for penicillin allergy
Drawing Cultures
● Blue/green (aerobic) first
● Purple/orange (anaerobic) last
Reassessment
● Endotoxic shock response shown by hypotension
● From gram- bacteria death
○ UTIs usually gram-
● Check bp after antibiotic administration
Non-bacterial Pathogens
● Virus can lead to bacterial infections
○ Still give antibiotics if viral
● Fungal pathogens mostly in immunocompromised
● Protozoal pathogens, like malaria
○ Question about foreign travel
● Temperature >100.4ºF or <96.8ºF
● Pulse >90bpm
● Respirations >20/min
○ Count for at least 30 seconds
Organ Dysfunction
● MAP <65mmHg
● SBP <90mmHg
● SBP decrease of 40mmHg from baseline
● Indicates severe sepsis
Comorbidities
● COPD worst with sepsis
● End-stage renal disease
● Sepsis becomes more morbid with pre-existing conditions
Antibiotics
● Give for sepsis even if patient is already taking antibiotics
○ Most people are non-compliant
○ If showing sepsis symptoms, it means patient is not using their antibiotics
○ If sepsis symptoms, follow protocol
● Culture sensitivity decreases after antibiotic administration
○ Blood cultures always before antibiotics
● Mortality increases by 10% for each hour without antibiotics
● Ceftriaxone safe for penicillin allergy
Drawing Cultures
● Blue/green (aerobic) first
● Purple/orange (anaerobic) last
Reassessment
● Endotoxic shock response shown by hypotension
● From gram- bacteria death
○ UTIs usually gram-
● Check bp after antibiotic administration
Non-bacterial Pathogens
● Virus can lead to bacterial infections
○ Still give antibiotics if viral
● Fungal pathogens mostly in immunocompromised
● Protozoal pathogens, like malaria
○ Question about foreign travel
