Sepsis & Systemic inflammatory response syndrome (SIRS)

Sepsis and SIRS are common and can be a major cause of morbidity and mortality in the critically ill.

Definitions

Causes

• Note that whilst SIRS can be caused by infection, there are many non-infective causes e.g.
  • Burns
  • Dehydration
  • MI
  • Cirrhosis
  • Haematological malignancy
  • Drugs/medications
  • Surgical procedures etc etc etc.

Management

• If there is a suspected infection + SIRS- SEPSIS 6
  1. Oxygen (aim for 94-98% unless COPD or sepsis induced hypotension/severe sepsis)
  2. Fluid resuscitation
  3. Blood (and other) cultures (e.g. urine, swabs etc)
  4. IV antibiotics
  5. Lactate, FBC and Biochem (urgent)
  6. Monitor urine output (catheterise if appropriate)
• see here for protocol sheet
• Antibiotics
  • IV Amoxicillin, Metronidazole and Gentamicin is protocol in Tayside for infection of unknown source
  • Review antibiotic man and investigation results and ammend as necessary if there is a known (/clinically suspected) source