Sepsis definitions and bundles, central line and catheter infections, C. difficile, isolation precautions and hospital outbreak response.
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- What is the Sepsis-3 definition of sepsis?
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Life-threatening organ dysfunction caused by a dysregulated host response to infection.- What are the three components of the qSOFA score?
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Respiratory rate 22 or more per minute, altered mentation, and systolic blood pressure 100 mmHg or less.- What is the SOFA score used for?
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To quantify the degree of organ dysfunction or failure in critically ill patients, including those with sepsis.- What serum lactate level supports a diagnosis of septic shock after fluid resuscitation?
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Greater than 2 mmol/L- What is the first-line vasopressor for septic shock?
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Norepinephrine- Within how many hours of recognizing sepsis should antibiotics be started?
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Within 1 hour- What is the recommended initial IV fluid bolus for sepsis with hypotension or lactate of 4 mmol/L or higher?
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30 mL/kg of crystalloid- Should blood cultures be drawn before or after antibiotics in suspected sepsis?
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Before, as long as drawing them does not significantly delay antibiotic administration.- What mean arterial pressure (MAP) goal is targeted with vasopressors in septic shock?
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65 mmHg or greater- Name the key actions included in the Surviving Sepsis Campaign hour-1 bundle.
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Measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics, begin rapid crystalloid fluids for hypotension or high lactate, and apply vasopressors if still hypotensive.- What are the SIRS criteria (older sepsis screening tool)?
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Temperature above 38C or below 36C, heart rate above 90/min, respiratory rate above 20/min (or PaCO2 below 32), and WBC above 12,000 or below 4,000/mm3.- What does CLABSI stand for?
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Central Line-Associated Bloodstream Infection- What is the most common group of organisms causing CLABSI?
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Coagulase-negative staphylococci- What skin antiseptic is recommended before central line insertion?
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Chlorhexidine (with alcohol)- What are 'maximal sterile barrier precautions' for central line insertion?
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Sterile gloves, sterile gown, cap, mask, and a large full-body sterile drape.
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