Sepsis Six Ppt
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Transcript of Sepsis Six Ppt
Septicaemia and “the sepsis six”
Patients perspective and medical management
Ling, Anita Sin YeeMohd Nazemi, Fatin Nurina | 18 March 2016
What is Septicaemia and Sepsis ?
• Blood poisoning• Sepsis : body's inflammatory reaction to a severe infection• Septicemia : the infection itself — it's defined as the bacteria
in the blood that causes sepsis.
Sepsis steps
Causes
• Most common : Bacterial infection• Can also be ; fungal, parasitic or viral infections
Symptoms :
Symptoms
SEPSIS SIX
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SIRS (Systemic Inflammatory Response Syndrome)
• Temperature > 38.5° C or < 36°C
• Heart rate > 2 SDs above normal, or bradycardia in children < 1 year old (< 10th centile for age)
• Respiratory rate > 2 SDs above normal (or pCO2 < 4.25Kpa)
• Leukocyte count > 12,000 cells/mm3 , < 4,000 cells/mm3 , or > 10% band forms
• Hyperglycaemia
• Altered mental status
• Hyperlactaemia
• Increased capillary refill time (CRT)
“Give 3” “Take 3”
Oxygen Serum Lactate
Fluid resuscitate Blood culture
IV Antibiotics Catheterise
Oxygen (O2)
Titrate O2 supplementation to saturations of 94 -98% or 88-92% in chronic lung disease
Fluid resuscitate
500ml bolus - give up to 30ml/kg
IV Antibiotics
Give IV antimicrobials according to local antimicrobial guidelines
Serum Lactate
Check lactate and full blood count
Blood Culture
Take blood cultures before giving antimicrobials
Catheterise
Assess urine output for accurate measurement in patients with severe sepsis/septic shock
3-hour bundle 1. Complete Sepsis 6 within first hour.
2. Administer a minimum of 30 mL/kg isotonic crystalloid for hypotension or lactate >4mmol/L
3. Assess patient for response to resuscitation by monitoring clinical and haemo-dynamic response, measure hourly urinary output and repeat lactate measurement.
6-hour bundle1. Apply vasopressors (for hypotension that does not respond to initial fluid
resuscitation) to maintain a mean arterial pressure (MAP) ≥ 65 mm Hg.
2. A sample fluid resuscitation algorithm is suggested as a guide to ongoing fluid resuscitation
3. Re-measure lactate as indicated.
Sepsis survivor
Relibility of the use of “sepsis six”
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