SIRS – systemic inflammatory response syndrome
\nTemp >100.4 or < 96.8
\nHeart rate > 90
\nRespiratory rate > 20
\nWBC > 12k or < 4k<\/p>\n
Two or more SIRS criteria and a source for infection = sepsis
\nSepsis + lactate > 4 or systolic blood pressure < 90 = severe sepsis
\nSevere sepsis where hypotension persists after fluid resuscitation = septic shock.<\/p>\n
Shock is hypoperfusion, hypoperfusion leads to anaerobic metabolism, which leads to increased lactate.<\/p>\n
Systemic inflammation leads to increased capillary permeability = leaky capillary beds = 2nd and 3rd spacing of fluid<\/p>\n
Levophed (norepi) is first line pressor for septic shock.<\/p>\n
CVP = garbage but measure it if your protocol demands it, 8-10 in spontaneously breathing patients, 10-15 in ventilated patients<\/p>\n
SVO2 – mixed venous oxygen saturation = > 70%, < 70% means poor oxygen carrying capacity – consider PRBCs or inotropic medications.<\/p>\n
a1 receptors – a for artery! – a1 agonists cause smooth muscle contraction (vasoconstriction)
\nb1 receptors – 1 for 1 heart! – b1 agonists increase cardiac contractility (beta blockers, aka b1 antagonists, \u00a0do the opposite)
\nb2 receptors – 2 for 2 lungs! – b2 agonists decrease bronchospasm and increase bronchodilation (albuterol)<\/p>\n","protected":false},"excerpt":{"rendered":"
SIRS – systemic inflammatory response syndrome Temp >100.4 or < 96.8 Heart rate > 90 Respiratory rate > 20 WBC > 12k or < 4k Two or more SIRS criteria and a source for infection = sepsis Sepsis + lactate > 4 or systolic blood pressure < 90 = severe sepsis Severe sepsis where hypotension […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-59","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/59","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=59"}],"version-history":[{"count":1,"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/59\/revisions"}],"predecessor-version":[{"id":60,"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/59\/revisions\/60"}],"wp:attachment":[{"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=59"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=59"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/edcrashcart.com\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=59"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}