This website uses cookies to ensure you have the best experience. Learn more

Instite Of Medicine Impact , Sepsis

3955 words - 16 pages

Surviving
A review of the
latest guidelines
By Julie Miller, BSN, RN, CCRN

2.0
ANCC
CONTACT HOURS

AFFECTING MILLIONS OF people worldwide, sepsis
is a systemic response to an overwhelming inflammatory
process caused by an infection. Approximately one in four
people who develop sepsis will die.1 In January 2013, the
international Surviving Sepsis Campaign Guidelines
Committee published its 2012 surviving sepsis guidelines
(SSG), an update to the 2008 guidelines for early identification and management of sepsis in adults.1 The
guidelines highlight the importance of screening every
potentially infected patient for sepsis and providing
best-practice interventions for managing ...view middle of the document...

1 Recognizing that a patient
has sepsis before it progresses to
severe sepsis is essential for early
intervention to prevent further
progression to septic shock.

Septic shock is sepsis-induced
hypotension that persists despite
adequate fluid resuscitation. Sepsisinduced hypotension is defined as
systolic BP (SBP) less than 90 mm
Hg, MAP less than 70 mm Hg, or a
decrease in SBP greater than 40 mm
Hg or less than two standard
deviations below normal for age
in the absence of other causes of
hypotension.1

Screening patients for sepsis includes monitoring for signs and
symptoms of infection and identifying subtle changes in vital signs,
mental status, urine output, lab values, and/or markers of tissue perfusion. (See Screening patients for sepsis, severe sepsis, or septic shock.)
Identifying sepsis quickly allows for
early goal-directed therapy, potentially reducing the patient’s mortality

Screening patients for sepsis, severe sepsis, or septic shock1
Sepsis

Severe sepsis

Septic shock

Suspected or documented infection plus
some of the following:

Criteria from previous column plus
any of the following thought to be
due to the infection:

All of the criteria from
previous columns
plus:

• sepsis-induced hypotension

• SBP 140 mg/dL in the absence
of diabetes)
Inflammatory variables
• white blood cell (WBC) count >12,000/mm3 or 10% immature forms (bands)

• acute lung injury with PaO2/FiO2
2.0 mg/dL
• bilirubin >2 mg/dL
• platelet count 40
mm Hg or less than
two standard
deviations below
normal for age
in the absence of
other causes of
hypotension

• plasma C-reactive protein more than two standard
deviations above the normal value
• plasma procalcitonin more than two standard deviations
above the normal value
Hemodynamic variables
• SBP 60 seconds)
• ileus (absent bowel sounds)
• thrombocytopenia (platelet count 4 mg/dL)
Tissue perfusion variables
• serum lactate >1 mmol/L
• decreased capillary refill or mottling

26 l Nursing2014 l April

Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

www.Nursing2014.com

Targeted time frames and goals of initial therapy1
Within 1 hour of recognition of severe sepsis or septic
shock initiate the following and complete within 3 hours:

Within 6 hours of recognition of severe sepsis or
septic shock:

• Obtain blood culture specimens before antibiotic administration.

• Infuse vasopressors (for hypotension that doesn’t respond
to initial fluid resuscitation or for abnormally low diastolic
BP) to maintain MAP of 65 mm Hg or greater; I.V. norepinephrine is first choice.

• Obtain serum lactate level.
• Administer broad-spectrum antibiotic (don’t delay more than
45 min for blood cultures).
• Initiate 30 mL/kg isotonic crystalloid fluids for hypotension or
lactate level of 4 mmol/L or greater (may use albumin as part
of initial fluid resuscitation in patients...

Other Papers Like Instite of Medicine Impact , Sepsis

Ignaz Semmelweis Essay

1291 words - 6 pages . Retrieved from http://www.brightknowledge.org/knowledge-bank/medicine-and-healthcare/famous-medicine/famous-doctors-ignaz-semmelweis Cork, D., Maxwell, P., & Yeo, C. (2011). Remembering Semmelweis: hand hygiene and its importance on today’s clinical practice. The American Surgeon, 77 (1), 123-125. Ellis, H. (2008). Ignaz Semmelweis: tragic pioneer in the prevention of puerperal sepsis. British Journal of Hospital Medicine (London, England

Sepsis Related Ards and Ptsd Essay

1121 words - 5 pages Sepsis Related ARDS and PTSD Sepsis Related ARDS and PTSD Acute respiratory distress syndrome (ARDS) is a traumatic life-altering illness that can be caused by sepsis. It can be especially traumatic if it is acquired as a young adult and Post-traumatic stress disorder (PTSD) develops as a person enters into later life. Re-living or even a perception, or fear of a reoccurrence of a traumatic event can manifest itself into PTSD. My PICO

Cam Essay

921 words - 4 pages claimed to assist in the healing or well-being of the patient. Integrative medicine is a combination of practices and methods of alternative medicine and conventional medicine to combine an optimal health and wellness program or health system. Conventional medicine does not impact alternative medicine in that this type of medicine does not have any scientific evidence or study, but is based on traditions and culture. Overall, CAM and western

Ventilated Associated Pneumonia

542 words - 3 pages Adapted from N Engl J Med 2006;355:2619-30. Host Risk Factors for VAP • Underlying pulmonary disease (e.g. COPD) • • • • • Sepsis ARDS Major surgery Multiple organ failure Head injury (traumatic and nontraumatic brain injury) Ann Intern Med. 2004;141:305-13. Other Risk Factors for VAP • Enteral nutrition • GI prophylaxis • Patient position (Head of bed elevation) • Patient receiving paralytic agent • Reintubation

Copd Case Study

2800 words - 12 pages see that she has a fever | 12 Lead EKG: Interpretation: Sinus tachycardia Clinical Significance: Tachycardia can be due to many possible explanations such as infection, anxiety or fever. All of which are all very likely for this patient. III. Clinical Reasoning Begins… 1. What is the primary problem that your patient is most likely presenting with? Pneumonia with COPD exacerbation and possible sepsis 2. What is the

The Use of Medical Technology to Prolong Life

3816 words - 16 pages effective is futile care? Opposition would have everyone believe that the cost is extremely high. When discussing futile care and cost, our contention is that there is no cost-effective method to maintain a patient’s care. Depending on the situation and how long the patient will be in need of the care, it can run a family anywhere from $100,00 to $1million and so on. What is the impact on nursing staff caring for the patient receiving futile

Hypoglycemia

840 words - 4 pages glucose of diabetes inaccurately matches the body's physiological need, and therefore causes the glucose to fall to a below-normal level. | | Diabetic hypoglycemia can occur in any person with diabetes who takes any medicine to lower their blood glucose, but severe hypoglycemia occurs most often in people with type 1 diabetes who must take insulin for survival. In type 1 diabetes, iatrogenic [caused by medicine] hypoglycemia is more

The Competent Nurse: the Movement Towards Baccalaureate Degree Nursing

943 words - 4 pages competencies is shown in the following patient care situation. First, let us review some of the background to this case study. This is an older woman who is morbidly obese (over 500 pounds). She lived at home with her husband and son. She arrived to the unit admitted with the diagnosis of sepsis. She had extensive pressure ulcerations caused by her immobility. She had been couch ridden for the last month. She had been refusing assistance at

Tissue Engineered Small Intestine

899 words - 4 pages , total parental nutrition is only long term medical therapy provided for short bowel syndrome. Approximately 40,000 patients receive total parental nutrition in the Unites States. Although the development of total parental nutrition was undoubtedly one of the greatest contributions to modern medicine and have managed to save many lives over the course of time. The prolonged use of total parental nutrition leads to the liver failure, and central

Mrsa Community

935 words - 4 pages Clinical significance MRSA is a strain of Staph Aureus which does not respond to treatment from antibiotic drugs such as cefoxitin and methicillin (1), (2). This is generally associated as an organism which colonises patients in a hospital setting. It can cause infections from soft tissue infections to sepsis, pneumonia, tissue damage and necrosis. Community acquired MRSA is not just a hospital acquired strain that has escaped into the

Hca 240 Kidney Failure Worksheet 2012

874 words - 4 pages CheckPoint Kidney Failure Week 6 Day 4 Resource: Ch. 11 of Human Diseases (Read)   Scenario A: Acute renal failure. Ms. Jones, a 68-year-old female, underwent open heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output. Answer questions 1-8 below. In each scenario, the patient is experiencing renal failure. 1. What is happening to Ms

Related Essays

He Impact Of The 2010 Institute Of Medicine (Iom) Report On The Future Of Nursing In Education, Practice And Leadership

867 words - 4 pages The Impact of the 2010 Institute of Medicine (IOM) Report on the Future of Nursing in Education, Practice and Leadership NRS-430V Professional Dynamics September 12 2012 This paper focuses on expanding the impact of Institute of Medicine report on future of nursing, leading change, advancing health and illustrates its impact on nursing education, practice and leadership. Focus of this report highlights re structuring of the health care

Marijuana Legalization Essay

1524 words - 7 pages - Drug-Free World. N.p., n.d. Web. 09 Dec. 2015. D'souza, Deepak Cyril, and Mohini Ranganathan. "Medical Marijuana." Journal of the American Medical Association: 313.24 (2015): n. pag. Web. 10 Dec. 2015. "Is Marijuana Addictive?" Is Marijuana Addictive? National Instite on Drug Abuse, n.d. Web. 10 Dec. 2015. "Is Marijuana Medicine?" DrugFacts:. National Instite on Drug Abuse, n.d. Web. 10 Dec. 2015.

Acute Care Essay

3142 words - 13 pages of Severe Sepsis and Septic Shock' Critical Care Medicine 2008 (36)296 Department of Health, National Early Warning Score National Clinical Guideline No. 1 (2013) Greenberg, CC et al. Patterns in communication breakdowns resulting in injury to surgical patients. Journal of American College of Surgeons. 2007; 204: 533-40 Kleinpell, R.: “Advances in Treating Patients With Severe Sepsis,” Critical Care Nurse. 23(3):16-29, 2003. Troels, T

Probiotics Essay

552 words - 3 pages “complementary” or “alternative” medicine. Available in supermarkets, pharmacies and health food stores. • • • • Sunday, April 20, 14 Brief History • • Ilya Metchnikoff (1845-1916) Awarded the Nobel Prize in 1908 for work on immunity Linked regular consumption of lactic acid bacteria in fermented dairy products to health and longevity in Bulgarian peasants. • Sunday, April 20, 14 Common Probiotics Used • Bacteria