The Overwhelming Infection of Septic Shock

2. Susan Oster, 45, is admitted to the hospital with a temperature of 38.5º C, heart rate 102 beats/min, respiration 20/min with septicemia and SIRS. WBC 12,500. Documentation states respiratory and acute hepatic failure are due to septicemia.

The unresolved infection has landed the patient on septic shock. Sepsis is the body’s response to inflammation of a particular or unknown infection. The presence of hypotension despite adequate fluid infusion and inadequate tissue perfusion is the result of septic shock. The treatment of shock is centered on the restoration of blood pressure to normal, the presence of adequate tissue perfusion, making sure organs return to functioning well, and avoiding further complications (Lewis, Dirksen, Heitkemper, Bucher, & Harding,

Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al.,

Septic shock is the leading cause of death for patients in intensive care units and is the final stage in a continuum of infectious and inflammatory processes. This continuum begins with bacteremia, which is the presence of bacteria in the blood. Normally the body’s immune system can fight off a localized infection caused by a small amount of bacteria in the blood and the person will remain asymptomatic. However, a hospitalized patient could be immunocompromised, have a

The Coalition for Sepsis Survival (C4SS) is a 501(c)(3) organization created to raise awareness among both the general public and healthcare providers and to facilitate the reduction of sepsis mortality and morbidity in the United States. The terms "coalition" and "survival" were purposefully selected to represent the core values of our vision and mission. "Coalition" underscores our philosophy to bring together hospitals, healthcare providers, and other organizations into a coordinated partnership committed to reducing the mortality and morbidity of sepsis for achieving the best outcomes and value for patient care. "Survival" represents our commitment to hospitals and clinicians to provide access to the tools and financial support for increasing a patient 's chance of survival and the best quality of life.

When a patient has sepsis early symptoms will include those that define SIRS; abnormal body temperature, increased heart rate, increased respiratory rate, and/or abnormal white blood cell count. If these symptoms are left untreated, organ failure will start to occur. Signs of organ failure can include decreased urine output, sudden changes in mental status, difficulty breathing, decrease in platelets and abnormal heart rhythms. Decreased cardiac output and hypotension may also start to occur, which indicates septic

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

This leads us to the next step in the pathophysiology of Sepsis. Stage 2 of sepsis, which is when SIRS plus the confirmation of an infection has been made. At this stage, the patient’s body has been continuously fighting something in their body and it is starting to have an effect on the patient. Signs and symptoms of sepsis are often nonspecific and include the following: Fever, chills, or rigors, Confusion, Anxiety, Difficulty breathing, Fatigue, malaise, Nausea and vomiting. It is important to identify any potential source of infection. Localizing signs and symptoms referable to organ systems may provide useful clues to the etiology of sepsis and are as follows: Head and neck infections: Severe headache, neck stiffness, altered mental

The aim of this assignment is to critically discuss the nursing assessment individualised care and nursing interventions of the acutely ill patient. The patient discussed developed severe sepsis due to a urinary tract infection and her condition deteriorated during the recovery process in the nurse’s care. Lovick (2009) defines sepsis ‘as a known or suspected infection accompanied by evidence of two or more of the SIRS criteria’. SIRS is outlined as a ‘systemic inflammatory response’ consisting of two or more of the following symptoms ‘temperature >38 degrees Celsius or 90 beats per minute, respiratory rates greater than 20 breaths per minute and white blood count higher than 12,000 cells per microliter or lower than 4000 cells per

There is a disease continuum with increasing severity if not treated or not responsive to treatment o Sepsis

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Is sepsis complicated by organ dysfunction, is diagnosed in more than 750,000 patients per year and has mortality rates as high as 28%-50%.

Septic shock is considered a form of distributive shock and is caused by excessive vasodilation and impaired distribution of blood flow (Gaieski & Mikkelsen, 2017a). It is characterised by the loss of vascular tone and displacement of vascular volume away from the heart and central circulation and presents with refractory hypotension despite fluid resuscitation (Neviere, 2017). As seen in Mr. Jones’ case the predominant haemodynamic feature of septic shock is arterial vasodilation (Neviere, 2017). The mechanisms implicated in this pathologic vasodilation are believed to multifactorial but the key influences are considered to be the activation and overproduction of the vasoactive substance nitric oxide and the activation of the adenosine triphosphate

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