Sepsis

Sepsis

Information Covered:

  1. Multiple Organ Dysfunction Syndrome (MODS)
    1. Sepsis
    2. Acute Respiratory Distress Syndrome (ARDS)
    3. Death of organs
    4. Death of organism
  2. Non Cardiogenic Shock
    1. Introduction
      1. Epidemiology
      2. Anatomic and physiologic differences in children
    2. Pathophysiology (compensated vs. decompensated)
      1. Hypovolemic
      2. Distributive (septic, neurogenic, anaphylactic)
    3. Assessment
      1. History (fever, vomiting, diarrhea, urine output, fluid intake, blood loss, allergic symptoms, burns, accidental ingestion)
      2. Physical findings (heart rate, blood pressure, capillary refill, color, petechiae, mental status, mucous membranes, skin turgor, face/lip/tongue swelling)
    4. Management
      1. Intravenous isotonic crystalloid for all types
      2. Septic: in-hospital antibiotics for presumed bacterial sepsis
      3. Anaphylactic: subcutaneous epinephrine, intravenous anti- histamines (diphenhydramine, ranitidine), and intravenous steroids
      4. Consider Pressors for ongoing decompensated shock
    5. Infectious injury
      1. Virulence or pathogenicity of microorganisms via
        1. Invading and destroying cells
        2. Producing toxins
        3. Producing hypersensitivity reactions
      2. Bacteria
        1. Survival and growth
        2. Bacteria produce enzymes or toxins
        3. Toxins
          • Exotoxins
          • Endotoxins
  3. Viruses
  4. Immunologic and inflammatory injury
  5. Injurious genetic factors
  6. Injurious nutritional imbalances
  7. injurious physical agents
  8. Manifestation of Cellular Injury
  9. Cellular Death/Necrosis
  1. The Cellular Environment
    1. Distribution of Body Fluids
      1. Intracellular fluid (ICF)
      2. Extracellular fluid (ECF)
      3. Total body water (TBW)
    2. Aging and Distribution of Body Fluids
    3. Water Movement Between ICF and ECF
    4. Water Movement Between Plasma and Interstitial Fluid
    5. Alterations in Water Movement – Edema
    6. Water Balance and the Role of Electrolytes
    7. Acid-base balances
    8. Multiple Organ Dysfunction Syndrome (MODS)

https://emedicine.medscape.com/article/168943-overview

https://www.mdcalc.com/sirs-sepsis-septic-shock-criteria

http://www.nejm.org/doi/full/10.1056/NEJMoa1415236#t=article

 

Content Creator: Ariel Wai

CAPCE Course Number: 17-EMTP-F3-1203

Total CE Hours: 1.25

Level: Advanced

EMT-CE uses the NEMSES guidelines as the foundation for every course outline.