Sepsis a Case Study

Pulse oximeter used to check his oxygen saturation level, which was 98% on air with no central or peripheral cyanosis. Since Mr Devi, does not seem to have any sign of abnormal respiration. The next assessment is circulation, where there are many physical signs to look for. The colour of the hand and digits, are they blue, pink, pale or mottled. Also need to measure for capillary refill time (CRT) by applying cutaneous pressure for 5 Sec on a fingertip held at heart level of Mr. Devi. The normal value of CRT is usually less than 2 second prolonged CRT suggests poor peripheral perfusion. Measure his Blood Pressure (B/P), count pulse rate by listening to the heart with a stethoscope or palpate peripheral and central pulses, assessing for the presence, rate, quality, regularity and equality. All of this assessment indicates the cardiovascular system in the patient is within the normal range or is there any emergency measures should take (Resus.org.uk 2016). However, Mr Devi’s circulation is a concern because his HR was 110bpm which is higher than normal range, the normal heart beat for adults ranges from 60-100bpm. Also his BP was 190/99mmhg with mean arterial pressure (MAP) of

40 year old man presents to A&E with lip swelling. Over the next 20 minutes he develops itching of the hands and feet, increasing breathlessness and chest tightness, fall in PEFR (peak expiratory flow rate) to 200l/min, fall in BP to 80/30mmHg and Oxygen saturations are 88% on room air.

Resuscitation in the ED. Rapid Quantitative resuscitation is recommended in all patients with tissue hypoperfusion. According to the SSC guidelines, the goals of fluid resuscitation include a CVP of 8-12 mm Hg, a MAP > 65 mm Hg, urine

Sepsis is a life-threatening and potentially fatal condition caused by the body’s reaction to an infection. Sepsis occurs when chemicals normally released in the bloodstream to fight infection trigger inflammation throughout the body. This can result in damage to multiple organs, which can cause organ damage and, in some cases, death.

After all the medications were given Mr. B’s vitals were as follows: Blood Pressure (BP) of

For the purpose of this assignment the patient will be given the pseudonym Susan to protect her privacy and confidentiality in line with the guidelines set out by the Nursing and Midwifery Council (NMC) (2015).

For decades prehospital providers have been treating trauma patients by initiating intravenous access and administering crystalloid fluids. The debate has been over what crystalloid fluid to administer for volume replacement, at what amount, and if we should be administering fluids at all. Many products are available and much research has been conducted with results showing that not all fluids are created equal. Some products have the ability to replace volume but provide little more benefit and may actually be harmful. Other products, when administered at much lower volumes, provide far greater benefits and greater potential for a positive outcome for the patient. Most ground ambulances carry Sodium Chloride 0.9% (Normal Saline) even though all research shows that its performance is inferior in comparison to other fluids. In this paper we will look at several recent studies, in which the effects of fluid administration/volume replacement in hypovolemic trauma patients are measured, with a concentrated look at normal saline.

An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.

To adhere with the Nursing and Midwifery Council, Code of Conduct (NMC, 2008) all patient details have been changed, to protect their identity from being revealed.

As a legal and professional obligation the Nursing and Midwifery Council (NMC) (2015) stipulate that all service users must have their confidentiality protected, therefore, the service user in this case study will be given the pseudonym of John.

Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.

Shock is described as a state of hypoperfusion of the organs and tissues, which results in cellular dysfunction and cell death. There are many varieties of shock, but for the purpose of this essay I will focus on hypovolemic shock. The term hypovolemic means low volume; this term in and of itself tells us what the root cause of this form of shock is, low blood volume. There are two different types of hypovolemic shock, hemorrhagic and non hemorrhagic. I will be discussing the possible causes, signs, symptoms, and treatment options for the hemorrhagic type. I will also explain what health care providers in the field should be looking for to determine whether the patient is in a state of compensated or decompensating shock. Compensated shock is when the body is using all of it’s resources to maintain perfusion but in the later stages of shock the patient will decompensate, this is when the body’s attempts at maintaining perfusion are beginning to fail.

In accordance with the Nursing and Midwifery Council,(NMC, 2015) The Code Professional standards of practice and behaviour for nurses and midwives on clause 5 Respect people’s right to privacy and confidentiality safeguarding patient information, no names or places will be disclosed. Therefore, throughout the following reflective case study, the patient will be referred to as Mariam. Patient

Following the Nursing and Midwifery Council (NMC) code of conduct (NMC, 2015) all the persons will be anonymised and confidentiality will be maintained.

Hadjiliadis, D. (2012, January 2). Septic Shock. New York Times. Retrieved November 23, 2013, from http://www.nytimes.com/health/guides/dise