Analyse The Importance Of Sepsis Prevention

The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format.

The aim of this assignment is to critically discuss the nursing assessment individualised care and nursing interventions of the acutely ill patient. The patient discussed developed severe sepsis due to a urinary tract infection and her condition deteriorated during the recovery process in the nurse’s care. Lovick (2009) defines sepsis ‘as a known or suspected infection accompanied by evidence of two or more of the SIRS criteria’. SIRS is outlined as a ‘systemic inflammatory response’ consisting of two or more of the following symptoms ‘temperature >38 degrees Celsius or 90 beats per minute, respiratory rates greater than 20 breaths per minute and white blood count higher than 12,000 cells per microliter or lower than 4000 cells per

Septic shock is the leading cause of death for patients in intensive care units and is the final stage in a continuum of infectious and inflammatory processes. This continuum begins with bacteremia, which is the presence of bacteria in the blood. Normally the body’s immune system can fight off a localized infection caused by a small amount of bacteria in the blood and the person will remain asymptomatic. However, a hospitalized patient could be immunocompromised, have a

Is sepsis complicated by organ dysfunction, is diagnosed in more than 750,000 patients per year and has mortality rates as high as 28%-50%.

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

Recognition of Sepsis in the ED. It is well known within health care professionals as well as the general public that, in the first hours of a myocardial infarction or cerebral vascular accident, time is tissue. This is also the case in severe sepsis and because of this, early recognition of sepsis is vital to improving outcomes. SIRS is the first line diagnostic for the recognition of sepsis. If the patient meets SIRS criteria, the next line of diagnostics is to test the serum lactate. Lactate is believed to be due to decreased end-organ perfusion, leading to anaerobic glycolysis and lactate production. Serum lactate is commonly used as a prognostic test for illness severity in ED patients with sepsis (Green et al., 2011).

There is a disease continuum with increasing severity if not treated or not responsive to treatment o Sepsis

Interlandi works with many hospitals and labs to get answers in order to not only expand her career but also inform the public of situations that need to be brought to their attention. Jeneen Interlandi’s position on this is valid because there are situations that can cause death/are life threatening but since the public isn’t informed they aren’t worried and feel secure when in fact they should be notified and worried. In Jeneen Interlandi’s article of “A Frightening New Risk In Heart Surgery” (2016) Interlandi informs the reader that people who are undergoing heart surgery aren’t being informed that recently there has been an outbreak of bacteria that has already caused many to become ill and potentially pass away. Interlandi also explains that the hospitals in which these outbreaks have occurred also have failed to notify the patients undergoing this procedure. In Interlandi’s article, “A Frightening New Risk In Heart Surgery” (2016), page 6, Interlandi states a source Lisa McGiffert, director of Consumer Report’s, “...hospitals aren’t taking enough responsibility.” “Without that notice, patients don’t know what symptoms to watch out for and can’t be promptly treated with

A total of 60 patients, mean age of 66.3 years and 86.7% male admitted to the ED and who received resuscitation using the standard EGDT algorithm for severe sepsis and septic shock and who were treated with CRRT because of septic AKI. The study conducted from June 2008 to February 2013 at a tertiary hospital in Seoul, Korea. The participants were assigned to two groups; on the basis of the median between the time they started the EGDT and the CRRT. The main outcomes measure the cause of 28-day mortality. The 28-day mortality rate was 43.3%. The overall cause of mortality rate was significantly higher for the late CRRT groups, than the early CRRT group 56.7 versus. 30.0%. The authors conclude that initiating CRRT early may be beneficial to improving mortality rate among patients with severe sepsis or septic shock, but indicate that more clinical trials are needed to accurately determine whether early CCRT is more efficacious than late CRRT in the treatment of septic

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Septic shock, a potentially lethal drop in blood pressure due to infection, is not completely understood even with the progress made in science and medicine throughout the years (Heuther & McCance, 2012). It is one of the most common causes of death in the intensive care unit (ICUs) in the United States of America each year, with a mortality rate of 28 to 60 percent (Heuther & McCance, 2012, p. 632). Septic shock is most commonly caused by bacteria, often gram-positive bacteria, acquired while in the hospital, and those who have conditions that reduce their ability to fight infection are most at risk (Young, 2008). This at risk population includes newborns, those over 35 years old, those with diabetes or cirrhosis,

Neonatal Sepsis Definition • Blood infection present in infant less than 3 months Cause • Bacteria • Group B streptococcus • Herpes Simplex Virus Risk Factors • Preterm delivery • Infection of placenta tissues and amniotic fluid • Prolonged hospital stay • Catheter in blood vessel for extended period of time S/S • Jaundice • Seizures • Decreased or increased HR • Low blood sugar • Abnormal breathing • Abnormal body temperature • Diarrhea • Vomiting Labs • Blood culture • CBC • C-reactive protein Treatment • IV antibiotics

An aspect where fluid resuscitation can be beneficial to the outcome of the patient is when sepsis is present. According to Bozza et al (2010), “hemodynamic instability plays a major role in the pathogenesis of systemic inflammation, tissue hypoxia, and multiple organ dysfunction in sepsis,” and that fluid therapy reduces mortality in these patients by helping to restore this imbalance. Thus establishing that fluid resuscitation can be beneficial in prehospital care as it assists in maintaining adequate organ and tissue perfusion. This evidence is also supported by Daniels (2011), who outlines that early diagnosis and early fluid therapy is associated with decreased mortality in sepsis patients, as maintaining a systolic blood pressure

‘Sepsis’, a lame man might hear of this word and have no clue or whatsoever of what this is – but in the real world it’s not something to be happy about and has been a major issue in the medical field. Sepsis is a complex condition which doesn’t have a specific definition, diagnosis or treatment but one thing the medical practitioners are specific of is the origin. Sepsis is from a Greek word called “Sepo” which means “decay” idiomatically known as “Blood poisoning” (Steen C., 2009). The medical field defines it as “Systemic Inflammatory Response Syndrome (SIRS) resulting from the presence of pathogens or their toxins as in septicaemia that occurs during an infected state.” (Sepsis Alliance, 2014). It is caused by a systematized

Types of bacteria known as gram negative bacteria were once primary cause of Sepsis. The recovery from Sepsis largely depends upon period of diagnosis as, in the case of early diagnosis, the chances are high for safe and speedy recovery. However, condition may get severe if diagnostic processes performed with any delay. The fact motivates me to propagate that public awareness should initiated so that timely diagnosis can be carried out because nothing much can be done once Sepsis progresses to higher stage. Therefore, my problem statement is to instigate public awareness so that they may quickly respond to condition like Sepsis (Mendonça et al,