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when you have an infection that has created a systemic inflammatory response Sepsis
systemic inflamatoory response syndrome have two of the following: >90bpm, >20 breaths per min, >38degrees C or 100.4F, temp <36C or 96.8F, WBC>12000or <4000
you have at least one end organ dysfunction, hypoperfusion or hypotension severe sepsis
you have sepsis induced hypotension that is persisting despite adequate fluid resuscitation septic shock
with this you need to measure lactate within 6 hours, blood cultures before antibiotics, broad spec. antibiotics with in 3 hours of ER, fluid bolus for hypotension or lactate >4, CVP >8 within 6 hours for septic shock, Resucitation Bundle
you need low dose steroids withing 24hours of dx of sepsis, drotecogin slfa (antiinflammatory) w/in 24hours, Glucose control 70-150, if on vent median inspiratory plateau pressure < 30 over 1st 24hrs to prevent further lung damage Management bundle
Every time a blood culture is ordered what else should be ordered lactate levels
targets microvasuclar dysfunction, reduce microvascular thrombosis Drotrecogin Alfa
do not give Drotrecogin Alfa if the patient has active internal bleeding, or epidual catheter
Created by: dnoyes