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Sepsis - Coggle Diagram
Sepsis
Investigations
Blood
FBE
CRP
Blood culture
LFT
UEC
Blood gas
Imaging
Chest x-ray
Abdo x-ray
Cardiac ultrasound
Other
LP
Urine
Late onset
CAKUT
Fungal infection
CMV
Stool PCR
Tracheal aspirate
Aetiology
Bacterial
GBS
E. Coli
Listeria
Streptoccus
Staph
Klebsiella
Anaeboric
Enterococcus
Viral
HSV
TORCH
Influenza / RSV
Enterovirus / Paracehovirus
Fungal sepsis
Candida
Skin integrity
Vascular devices
Steroids
Management
Airway / breathing
Intubation / Mechanical ventialtion
NIV
IV
Recurrent apnoea
Respiratory failure
Primary lung disease / ARDS
Lung protective ventilation
PPHN
Inotropic
Intracranial pathology
Circulation
Warm shock (Vasodilation)
Vasoconstriction
Noradrenaline (a > > b)
Adrenaline (a = b)
Dopamine
Increased PVR
Dose dependant
Vasopressin (ADH - supraphysiological) - Hyponatraemia
Cold shock
Dobutamine (b)
Dopamine (low dose)
Adrenaline
Milrinone (phosphodisterase 3(
Hydrocortisone
minerolocorticoid = glucocorticoid
Inherent adrenal insufficiency
Upregulated A / B receptor
Antiinflammatory
ECMO (Extracorporal membranous oxygenation)
Reversible, not life limiting, size (> 2kg), coagulopathy / ICH
Cardiac support (VA ecmo)
Volume expansion
Normal saline (10 ml/kg)
Blood products
Albumin (4% or 20%)
Antimicrobial and Anti viral
Early onset
Benzylpenicillin
60mg/kg
90mg/kg
Gentamicin
Renal toxicity
Ototoxivity
Cefotaxime
Meningitis
Renal impairment
ESBL
Meropenem
Late onset
Flucloxacillin
Gentamicin
Vancomycin
No clinical improvement
MRSA
Antivirals :
Aciclovir
Gancyclovir
oseltamivir
Antifungal
Fluconazole
Amphotericin
Clinical assessment
History
Poor feeding
Fever
Lethargy
Irritability
Apnoeas
Exam
Temperature instability
ABDs
Hypotension
Tachycardia
Tachpynoea
Poor tone / increased tone
Bulging fontanelle
Feed intolerance / Abdo distention
Decreased urine output
Perfusion - vasodilation or vasoconstriction