Sepsis for NursesFakhir Raza Haidri

Intensivist

What is sepsis• Definition• Identification• Early management by the nurse• Expected orders• Time management

Definition• Sepsis is a life-threatening condition that arises when the body's

response to an infection damages its own tissues and organs. • It can lead to shock, multiple organ failure, and death, especially if it is

not recognized early and treated promptly.

Identification or recognition of sepsis• SOFA and qSOFA• Sequential Organ Failure Assessment

A high risk patient has 2 of

1.GCS 13 or less 2.Systolic BP < 100 3.Respiratory rate > 22

This is qSOFA

Septic shock• sepsis with underlying circulatory and cellular/metabolic

abnormalities profound enough to substantially increase mortality (>40%).

•  Persisting hypotension requiring vasopressors to maintain MAP > 65 and serum lactate >2 mmol/L despite adequate volume resuscitation

SEPSIS SIX details

The Sepsis Six1. Give high-flow oxygen via non-rebreathe bag

2. Take blood cultures and consider source control

3. Give IV antibiotics according to local protocol

4. Start IV fluid resuscitation Hartmann’s or equivalent

5. Check lactate Repeat if high in 4 hours maximum

6. Monitor hourly urine output consider catheterisation

within one hour

What can you do• Identify qSOFA and SOFA• Start Oxygen• Inform Doctor: remind about possibility of sepsis• Maintain IV access• Send all the labs including cultures ordered with in one hour• Give fluids as ordered within one hour• Give antibiotics as ordered within one hour• Measure strict urine output every hour