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Pneumonia and Sepsis By Oliver Putt and Priyanca Patel For WMS Peer Support – 11 th November 2014
SIRS Systemic Inflammatory Response Syndrome It is not a diagnosis but the body’s response to an unknown pathogenic process Your patient is not feeling well
How to identify SIRS? The patient must have two or more of:
How to identify SIRS Temperature >38 o C or <36 o C
How to identify SIRS Heart rate: >90BPM
How to identify SIRS Respiratory rate >20 min -1 or pCO 2 <32mmHg
How to identify SIRS White cell count <4x10 9 /dl or >12x10 9 /dl
How do you identify SIRS?
How to identify SIRS
Sepsis SIRS with a known (or suspected) infection You patient is not feeling well and you know why
Severe Sepsis Sepsis with organ dysfunction You patient is not feeling well, you know why and now their body is struggling to cope
Septic Shock Sepsis with hypotension SBP <90mmHg
Septic Shock Despite fluid resuscitation
Septic Shock With perfusion abnormalities
Septic Shock Septic shock = sepsis + hypotension + perfusion abnormalities
The Sepsis Six Within 1 hour of suspecting sepsis you must implement the sepsis six care bundle Take 3 Give 3
Take 3 1. Blood cultures (Before antibiotics)
Take 3 2. FBC and serum lactate
Take 3 3. Start urine output measurements
Give 3 1. High flow oxygen
Give 3 2. Empirical IV antibiotics
Give 3 3. Fluid resuscitation
Pneumonia Infection and inflammation of the alveoli
Pathogens of pneumonia Community acquired: Influenza virus Streptococcus pneumoniae Hospital acquired: Staphylococcus aureus
Symptoms of pneumonia Dysponea Cough Sputum production Pleurisy
Signs of pneumonia Fever Tachypnoea Crackles Bronchial breath sounds
Investigations for pneumonia Peak expiratory flow rate (PEFR) Full blood count (FBC) Urea & electrolytes (U&Es) C-reactive protein (CRP) Lactate Arterial blood gases (ABGs) Chest radiograph (CXR) Nose & throat swabs : for viral investigations (PCR tests) Sputum
Treatment of pneumonia Community acquired: Amoxicillin Clarithomycin Hospital acquired: Piperacillin - tazobactam
When would you admit a patient with community acquired pneumonia?
CURB - 65 Confusion Urea >7mmol/l Respiratory rate >30/min Blood pressure <90mmHg (systolic) <60mmHg (diastolic) 65 years or older
CURB-65 – The Results >1 Admit >2 IV treatment
Yong Lee ICU Registrar John Hunter Hospital
Community Acquired Pneumonia Guidelines 2011 Top 11 Recommendations Michael H. Kim.
SEPSIS KILLS program Adult Inpatients
Wes Theurer, DO. Recognize sepsis early Understand therapeutic principles Cultures before antibiotics Crystalloid fluid resuscitation Antimicrobials.
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Judy Bedard RN, MSN/ED. I do not have any affiliation with Laerdal Corporation that offers financial support for this educational activity.
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Nikola Bla ž evi ć Mentor: A. Ž mega č Horvat. - inflammation of the lungs caused by infection - many different causes: bacteria, viruses, fungi, idiopathic.
Pneumonia Why do we need to know about it? Long recognized as a major cause of death, Pneumonia has been studied intensively since late 1800s. Despite.
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SECONDARY LOBULE Normal lung histology Normal lung histology Inflammatory Cells lsPneumonia Inflammatory Cells lsPneumonia.
Click the mouse button or press the space bar to display information. A Guide to Communicable Respiratory Diseases Communicable diseases can be spread.
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