Sepsis

Course overview

Objectives Describe the major concepts and treatment options for sepsis Describe the cellular processes involved in sepsis Explain EMS role in treating sepsis patients Content Multiple Organ Dysfunction Syndrome MODS 1 Sepsis 2 Acute Respiratory Distress Syndrome ARDS 3 Death of organs 4 Death of organism 2 Non Cardiogenic Shock 1 Introduction 1 Epidemiology 2 Anatomic and physiologic differences in children 2 Pathophysiology compensated vs decompensated 1 Hypovolemic 2 Distributive septic neurogenic anaphylactic 3 Assessment 1 History fever vomiting diarrhea urine output fluid intake blood loss allergic symptoms burns accidental ingestion 2 Physical findings heart rate blood pressure capillary refill color petechiae mental status mucous membranes skin turgor face lip tongue swelling 4 Management 1 Intravenous isotonic crystalloid for all types 2 Septic in hospital antibiotics for presumed bacterial sepsis 3 Anaphylactic subcutaneous epinephrine intravenous antihistamines diphenhydramine ranitidine and intravenous steroids 4 Consider pressors for ongoing decompensated shock 5 Infectious injury 1 Virulence or pathogenicity of microorganisms via 1 Invading and destroying cells 2 Producing toxins 3 Producing hypersensitivity reactions 2 Bacteria 1 Survival and growth 2 Bacteria produce enzymes or toxins 3 Toxins Exotoxins Endotoxins 3 Viruses 4 Immunologic and inflammatory injury 5 Injurious genetic factors 6 Injurious nutritional imbalances 7 Injurious physical agents 8 Manifestation of cellular injury 9 Cellular death necrosis 1 The cellular environment 1 Distribution of body fluids 1 Intracellular fluid ICF 2 Extracellular fluid ECF 3 Total body water TBW Aging and distribution of body fluids Water movement between ICF and ECF Water movement between plasma and interstitial fluid Alterations in water movement edema Water balance and the role of electrolytes 7 Acid base balances Multiple Organ Dysfunction Syndrome MODS