(精选)Recognising sepsis and taking action - Dr Michelle Webb - KSS PSC教学课件.pptVIP

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(精选)Recognising sepsis and taking action - Dr Michelle Webb - KSS PSC教学课件.ppt

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Dr Michelle WebbRenal Consultant, Associate Medical Director Patient Safety, East Kent Hospitals University NHS Foundation Trust and Co-lead for Sepsis Kent Surrey Sussex Patient Safety Collaborative Recognising sepsis and taking action /safety Sepsis Sepsis is a life threatening condition that arises when the body’s response to an infection injures its own tissues and organs. It can occur as a consequence of any infection Failure to recognise early and treat agressively can lead to shock, multiple organ failure and death. Who is most at risk? The very young and the very old Pregnant women Immunosuppressed Chemotherapy Drug treatments for immune disorders eg rheumatoid arthritis Transplant patients Those with Chronic Diseases eg diabetes The Facts Incidence UK 100,000 annually 35,000 + deaths per year in UK. More than breast and bowel cancer combined Incidence increased by 8-13% over last decade Third highest cause of mortality in hospital setting Commonest reason for admission to ITU On average 2 children die per day Basic interventions reliably delivered to 80% of patients could save 11,000 lives and ￡150 million Fig.?3 Crit Care Med 2006;34(6):1589–96 Delayed Initiation of antimicrobial therapy increases mortality Surviving Sepsis Campaign Aim was to reduce deaths from sepsis by 25% by 2009 Introduced Sepsis Six ? 6 elements High flow oxygen Take blood cultures IV antibiotics within 1 hour, “golden hour” IV fluid resuscitation Check lactate Monitor urine output Why do cases get missed? Infection and Sepsis are a continuum Young people are good at masking signs Early symptoms can be “a flu like illness” or diarrhoea and vomiting Respiratory Rate is the most sensitive early indicator and the least likely to be recorded in the community setting Relationship between Lactate and Mortality Sepsis can be caused by a huge variety of different bugs, most cases being caused by common bacteria which we all come into contact with every day without them makin