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

sirs

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
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