terry white, mba, bsn sepsis. sirs systemic inflammatory response system sirs is a widespread...
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![Page 1: Terry White, MBA, BSN SEPSIS. SIRS Systemic Inflammatory Response System SIRS is a widespread inflammatory response to a variety of severe clinical injuries](https://reader036.vdocument.in/reader036/viewer/2022062304/56649eb35503460f94bb9d3d/html5/thumbnails/1.jpg)
Terry White, MBA, BSN
SEPSIS
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SIRS
Systemic Inflammatory Response System• SIRS is a widespread inflammatory response to a variety of
severe clinical injuries. This syndrome is clinically indicated by the presence of 2 or more of the following• Temp >38%C or <26%C
• HR > 90/min
• RR > 20/min or PaCO2 <32mm/HG
• WBC >12 or <4, or with > 10% immature band forms
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Sepsis
• Sepsis• In sepsis, the clinical signs of SIRS are present together
with the definitive evidence of infection
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SEVERE SEPSIS
• Severe Sepsis• Sepsis is considered severe when it is associated with organ
dysfunction, hypoperfusion, or hypotension
• The manifestations of hypoperfusion may include lactic acid, oliguria, and an acute alteration in mental status
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SEPTIC SHOCK
• Septic Shock• Is sepsis with hypotension despite adequate fluid replacement
combined with perfusion abnormalities that may include• Lactic acidosis• Oliguria• Acute alteration in mental status
Patients who require inotropic or vassopressor support despite adequate fluid replacement are in septic shock
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MODS
• Multiple Organ Dysfunction Syndrome• Refers to the presences of altered organ function in an
acutely ill patient such that homeostasis cannot be maintained without intervention
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RISK FACTORS• Extreme age (<1 yr and >65yrs)• Malnutrition• Hypothermia• Use of Central line catheters• Endotracheal intubation/mechanical ventilation• Aspiration• Chronic illness (Diabetes, RF, Hepatic failure)• Immunodeficiency (AIDS, Alcoholism, chemo)• Use of surgical/invasive procedures
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TREATMENT
• POSSIBLE TREATMENTS• Fluid replacement• Control of blood pressure• Tissue perfusion• Early treatment with antibiotics• Administration of steroids for adrenal insufficiency• Control of glucose levels• Protective lung ventilation• Administration of activated protein C