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Septic and Shock

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Lana Iris
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4 views

Septic and Shock

Uploaded by

Lana Iris
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Septic and shock

Sepsis is defined as life-threatening organ


dysfunction due to dysregulated host response
to infection, and organ dysfunction is defined
as an acute change in total Sequential Organ
Failure Assessment (SOFA) score of 2 points or
greater secondary to the infection cause.
Septic shock occurs in a subset of patients with
sepsis and comprises of an underlying
circulatory and cellular/metabolic abnormality
that is associated with increased mortality.
Septic shock is defined by hypotension require
vasopressors to maintain a mean arterial
pressure of 65 mm Hg or higher and a serum
lactate level greater than 2 mmol/L (18 mg/dL)
despite adequate volume resuscitation.
Signs and symptoms
The specific clinical features depend on where
the patient falls on that continuum.Signs and
symptoms of sepsis are often nonspecific and
include the following:
1.Fever (usually >101°F [38°C]), chills, or rigors
2.Confusion
3.Anxiety
4.Difficulty breathing
5.Fatigue, malaise
7.Nausea and vomiting.
7.In sepsis, symptoms may include decreased
urine output and cyanosis (blueish
discoloration of the lips and/or digits).
Alternatively, typical symptoms of systemic
inflammation may be absent in sepsis,
especially in elderly individuals.
 It is important to identify any
potential source of infection. Localizing
signs and symptoms referable to organ
systems may provide useful clues
Etiology
1.head and neck infections – Severe headache,
neck stiffness, altered mental status, earache,
sore throat, sinus pain/tenderness,
cervical/submandibular lymphadenopathy
2.Chest and pulmonary infections – Cough
(especially if productive), pleuritic chest pain,
dyspnea, dullness on percussion, bronchial
breath sounds, localized rales, any evidence of
consolidation
3.Cardiac infections – Any new murmur,
especially in patients with a history of
injection or IV drug use
4.Abdominal and gastrointestinal (GI)
infections – Diarrhea, abdominal pain,
abdominal distention, guarding or rebound
tenderness, rectal tenderness or swelling
5.Pelvic and genitourinary (GU) infections –
Pelvic or flank pain, adnexal tenderness or
masses, vaginal or urethral discharge, dysuria,
frequency, urgency
6.Bone and soft-tissue infections – Localized
limb pain or tenderness, focal erythema,
edema, swollen joint, crepitus in necrotizing
infections, joint effusions
7.Skin infections – Petechiae, purpura,
erythema, ulceration, bullous formation,
fluctuance

Diagnosis
Patients with sepsis may present in a myriad
of ways, and a high index of clinical suspicion
is necessary to identify subtle presentations.
The hallmarks of sepsis and septic shock are
changes that occur at the microvascular

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