ACUTE ONSET SEPSIS PROTOCOL
Patients who undergo certain procedures are at an increased risk for sepsis. Some interventional procedures such as biliary tube (PTC) and nephrostomy tube (PCN) procedures have a higher propensity to experience acute on septic shock.
Symptoms of sepsis patients may exhibit:
- Chills
- Tachycardia
- Hypotension
- Fever like symptoms
- Late onset multisystem organ failure
- IV NS Fluid bolus
- Demerol 12.5-25mg IV for shaking effects
- Antibiotic therapy as prescribed by M.D.
A. Vancomycin lgm IVPB
B. Cleocin (Clindamycin) 600 mg IVPB
C. Azactam 1gm IVPB
D. Flagyl 500 mg IVPB
- Toradol 30-60mg IV for anti inflammatory effect (Caution if patient allergic to NSAIDS or if GI Bleed)
Frequently Asked Questions
What is the acute sepsis protocol for patients undergoing procedures?
The acute sepsis protocol for patients undergoing high-risk procedures like biliary or nephrostomy tube placements involves monitoring for symptoms such as chills, tachycardia, and hypotension. Treatment includes administering IV normal saline for fluid resuscitation, Demerol for shaking, and prescribed antibiotics like Vancomycin, Clindamycin, Azactam, or Flagyl. Toradol may be given for its anti-inflammatory effects unless contraindicated due to allergies or gastrointestinal issues.
What symptoms indicate acute sepsis in patients?
Symptoms of acute sepsis can include chills, rapid heartbeat (tachycardia), low blood pressure (hypotension), fever-like symptoms, and in severe cases, late-onset multisystem organ failure. Recognizing these signs early is crucial for timely intervention and treatment to prevent further complications.
Why are biliary and nephrostomy procedures high risk for sepsis?
Biliary and nephrostomy procedures are high risk for sepsis because they involve invasive techniques that can introduce bacteria into the body. These procedures create pathways for potential infection, which can lead to a systemic inflammatory response if not managed properly with aseptic techniques and prophylactic measures.
What antibiotics are typically used in sepsis treatment protocols?
In sepsis treatment protocols, antibiotics are tailored to the suspected or confirmed pathogen. Common choices include Vancomycin for broad-spectrum coverage, Clindamycin for Gram-positive bacteria, Azactam for Gram-negative coverage, and Flagyl for anaerobic infections. The choice depends on the clinical scenario and physician discretion.
How does IV fluid bolus help in managing sepsis?
Administering an IV fluid bolus, typically with normal saline, helps manage sepsis by increasing blood volume, improving circulation, and stabilizing blood pressure. This resuscitation strategy aims to counteract the hypotension and potential shock associated with sepsis, ensuring vital organs receive adequate perfusion.
What can trigger septic shock during medical procedures?
Septic shock during medical procedures can be triggered by the introduction of bacteria into the bloodstream, often due to invasive techniques or compromised sterile fields. This can lead to systemic inflammation, causing blood vessels to dilate and blood pressure to drop dangerously low, necessitating immediate medical intervention.
Why is Toradol used in sepsis protocols, and what precautions are needed?
Toradol, an anti-inflammatory medication, is used in sepsis protocols to help reduce inflammation and provide pain relief. However, it is contraindicated in patients with NSAID allergies or a history of gastrointestinal bleeding. Careful assessment is needed to avoid adverse reactions, ensuring safe administration.