Sepsis: Early Detection and Implementation of Sepsis Resuscitation Bundle

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Sepsis: Early Detection and Implementation of Sepsis Resuscitation Bundle

Sepsis is defined as the body’s inflammatory response to an infection and can quickly lead to multiple organ failure and death. Early, goal-directed therapy using the sepsis resuscitation bundle introduced in the “Surviving Sepsis Campaign” is the treatment used throughout the world for sepsis treatment (Winterbottom 2012, pp 247). There are approximately one million cases of sepsis in the United States annually and deaths total more than prostate cancer, breast cancer, and HIV/AIDS combined. Also, more than one-fourth of patients that develop sepsis will develop it on a medical-surgical unit and severe sepsis is the most common cause of
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The priority assessment for sepsis is identifying patients at highest risk for sepsis, although all patients should be monitored for clinical manifestations. Patients at increased risk include those with chronic illnesses, under one year old or older than 85 years old, the immunosuppressed, postoperative patients, and those debilitated or with poor nutrition (Bernstien 2013, pg 25). To identify sepsis early the nurse will need to look for a respiratory rate of >20, heart rate >90, temperature >100.4 or < 96.8*F, and a white blood cell count of >12,000 cells/mm3 or < 4,000 cells/mm3. Assessments after the resuscitation bundle has begun would include respiratory, cardiovascular, integumentary, urinary, and neurological systems, as well as laboratory values. Respiratory would be assessed for rate and oxygen saturation. Central venous pressure, mean arterial pressure, systolic blood pressure, pulse quality and peripheral pulses would be assessed for the cardiovascular system. Skin would be assessed for warmth, color, and whether it is clammy or dry. Skin would also be assessed for petechiae, ecchymosis, or bleeding of mucous membranes to ensure disseminated intravascular coagulation (DIC) has not begun. Urinary output would be monitored to ensure adequate perfusion to the kidneys and for signs of urinary tract infections. Neurological would be assessed for any changes from baseline mental status. The most important

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