# Sepsis --- **Sepsis** is a serious condition where the body's own [[immune system|immune response]] leads to a massive inflammatory reaction, which can cause organ damage. Sepsis, if untreated can lead to [[shock#Distributive Shock|septic shock]], which is very dangerous with a mortality of 40%. This number has actually gotten better in recent years as early detection has been emphasized in the hosptial setting. Sepsis can lead to additional conditions such as [[acute respiratory distress syndrome|ARDS]]. Common reasons a person may get sepsis are untreated bacterial infections: - [[urinary tract infection|UTIs]] are a common cause, especially in older adults who may have asymptomatic UTIs - [[pneumonia]] - etc. If sepsis is suspected most hospitals initiate a rapid sepsis protocol, which includes - measuring [[lactate]] levels - lactate indicates cells are resorting to [[cellular respiration|anaerobic respiration]], which indicates oxygen is not reaching the tissues - obtaining [[labs#Blood Tests|cultures]] to identify the causative agent - If at all possible, as a general rule draw these before administering antibiotics - administer broad spectrum antibiotics - if/when the culture gets back they can dial this in - administer a bolus of fluids to maintain hemodynamics - if bolus is unsuccessful, administer vasopressors. ![[1 hour sepsis bundle.png]] Some other treatments can be like: - blood sugar control - try to keep it low without letting them get hypoglycemic because bacteria feed on bloodsugar - DVT and PUD prophylaxis ## SOFA Score The **Sequential Organ Failure Assessment**, or **SOFA** score is a tool that can be used to broadly predict mortality from sepsis, based on quick assessments. A quick SOFA, or a **qSOFA** is a down and dirty SOFA evaluation that a nurse can do very rapidly, that does not involve looking at labs or anything like that: - respiration rate 22 or higher - altered mental status - i.e. [[level of consciousness|Glasgow Coma Scale]] below 15 - systolic blood pressure lower than 100 ## Sepsis in Pediatric Patients There are some different changes that we might see with children in sepsis. How do Pediatric Patients with Sepsis Present Differently? Skin color changes and tachycardia are common indicators Hypotension comes later in children than adults- need to treat prior to hypotension ___