Sepsis

Definition   Life-threatening organ dysfunction caused by a dysregulated host response to infection, arising when the body's response to infection injures its own tissues and organs.

Cause  Macrophages, leukocytes and neutrophils flood area due to infections which causes inflamation. They also cause damage to endothelium which leads to vascular permabily and capilleries become leaky. This leads to nitrc oxide and other cytokines building up, which act as vasodilators, which leads to BP dropping, intravascular fluid loss, decreased perfusion of cells and tissues, then to anaerobic respiration and lactic acid. Liver and kidneys struggle to deal with lactic acid which causes lactic acidosis and restricted cardic function and resp rate goes up to try to get more oxygen.  

Symptoms
-  Infection (signs eg fever, redness, swelling, discharge, green sputum, urine smell)
-  Resps 22/min or above     
-  Systolic BP under 100
-  Altered cognition  
                        Think Sepsis if any NEWS2 score is a 3  or total NEWS2 is 5 or above.

Action   Full ABCDE assessment 
               Give:  1 Oxygen    2. Antibiotics IV    3.  Fluid
              Take:  1. Blood Cultures    2. Measure lactate    3. Measure Urine

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