SEPTIC SHOCK

SEPTIC SHOCK

1. Interventions/Treatment

   • Rosini, J. M., & Srivastava, N. (2013). The 2012 Guidelines for Severe Sepsis and Septic Shock: An Update for Emergency Nursing. JEN: Journal Of Emergency Nursing, 39(6), 652-656. doi:10.1016/j.jen.2013.07.012

2. Nursing Considerations

   • Oxygenation and respiratory function are priority
   • Proper positioning
   • ABGs monitored
   • Circulatory function addressed with combination of fluids and medications
   • Monitor:
     • Vital signs
     • body temperature
     • hemodynamic function
     • urine output
     • level of consciousness

3. Signs and Symptoms

   • Body temperature >38C or <36C
     • influences tachycardia
   • Heart rate >90 beats/min
     • indication of tachycardia and hypovolemia
   • Respiratory rate >20 breaths/min
     • Compensation for metabolic acidosis
   • White blood cell count >12 000 /mm3 or <4 000/mm3
   • Altered mental status
     • Hypoperfusion can show as disorientation or confusion
   • Apprehension, anxiety, agitation
   • Wolf, L. (2012). Early Recognition and Treatment of the Septic Patient in the Emergency Department. JEN: Journal Of Emergency Nursing, 38(2), 195-197. doi:10.1016/j.jen.2011.11.006

4. Pathophysiology

   • Wolf, L. (2012). Early Recognition and Treatment of the Septic Patient in the Emergency Department. JEN: Journal Of Emergency Nursing, 38(2), 195-197. doi:10.1016/j.jen.2011.11.006
   • The presence of systemic inflammatory response syndrome (SIRS) in the setting of infection
   • SIRS causes vasodilation and capillary permeability causing hypotention, hypoperfusion, metabolic acidosis, elevated lactate levels and multisystem organ failure

5. References for now

   • Bridges, E. (2017). RESEARCH IN REVIEW: ADVANCING CRITICAL CARE PRACTICE. American Journal Of Critical Care, 26(1), 77-88. doi:10.4037/ajcc2017609
   • Garretson, S., & Malberti, S. (2007). Understanding hypovolaemic, cardiogenic and septic shock. Nursing Standard, 21(50), 46-60.