Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2
Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2
Infectious DiseasesNeil Jorgensen Marina MorieSEPSIS AND SEPTIC SHOCKInitial Assessment1Definitions (SCC 2016)a.Sepsis: “Life-threatening organ dysfun Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2nction caused by dysregulated host response to infection"b.Septic shock: “Subset of sepsis with circulatory and cellular/inetabolic dysfunction associated with higher risk of mortality”2Diagnosis of sepsisa.ssc 2016, NICE 2016: No diagnostic test to define sepsis; clinical diagnosis; treat if suspec Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2ted or at risk of having sepsisSepsis-3 2016: Clinical Criteria for Sepsis: Infection Plus Two or More Points from SOFA Score (See Table 6-1) If Not iEbook Current practice guidelines in inpatient medicine 2018–2019: Part 2
n ICU, May Use qSOFA Score (Easier Than SOFA)1Diagnosis of septic shocka.Sepsis-3 2016: Despite adequate fluid resuscitationi.Vasopressors required toInfectious DiseasesNeil Jorgensen Marina MorieSEPSIS AND SEPTIC SHOCKInitial Assessment1Definitions (SCC 2016)a.Sepsis: “Life-threatening organ dysfun Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2 (behavior/circulalion/respiralion) + risk factors for sepsis' —* Stratify risk of severe illness'1Acute Medical ManagementI.Initial resuscitationa.see 2016i.(live at least 30 ml./kg of IV crystalloid (I.R, NS) within 3 hours'Risk factors for sepsis: Age >75 years or <1 year, frail with comorbiditie Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2s, trauma/surgery/invasive procedure within last 6 weeks, impaired immunity, indwelling lines, IV drug use, skin breach (cuts, burns, infection, blistEbook Current practice guidelines in inpatient medicine 2018–2019: Part 2
ers), pregnant/pregnant in last 6 weeks (particularly if: diabetes or gestational diabetes, c section/forceps/invasive procedure/retained products, prInfectious DiseasesNeil Jorgensen Marina MorieSEPSIS AND SEPTIC SHOCKInitial Assessment1Definitions (SCC 2016)a.Sepsis: “Life-threatening organ dysfun Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2on risk assessment, based on behavior, history, breathing, circulation, skin, temperature, and urine, which can be found at httix//www.bmi.com/content/354/bmi.i40.Winfocrai>hic.CHAPTER 6TABLE 6-1SOFA SCORE FOR SEPSISSOFA Score(Nor recognized by Surviving Sepsis Campaign as diagnostic crirerium):Scre Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2en positive if >2 points above baseline of:Criteria/points 1234Glasgow coma scale13 1410 126 9<6PaO2:FiO2 ratio<400<300<200 (w/support)<100 (w/ supporEbook Current practice guidelines in inpatient medicine 2018–2019: Part 2
t)Systolic blood pressureMAP <70Dopamine <5 orDopamine >5 or epinephrineDopamine: 15 or epinephrine(vasopressor required)Any dose of dobutamine<0.1 orInfectious DiseasesNeil Jorgensen Marina MorieSEPSIS AND SEPTIC SHOCKInitial Assessment1Definitions (SCC 2016)a.Sepsis: “Life-threatening organ dysfun Ebook Current practice guidelines in inpatient medicine 2018–2019: Part 2 mg/ dL1.2-1.92.0-5.96.0-11.9>12.0Infectious DiseasesNeil Jorgensen Marina MorieSEPSIS AND SEPTIC SHOCKInitial Assessment1Definitions (SCC 2016)a.Sepsis: “Life-threatening organ dysfunGọi ngay
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