Sepsis Scenario

What medical term describes ‘acute confusion’?

You note the patient’s delirium; normally she is fully conversant, sharp, and has no history of dementia symptoms. You complete her observations: HR 112, SpO₂ 93%, RR 28, BP 86/46, Temp 38.6, BM 9.6. What is this patient’s NEWS score? 

You are immediately concerned about the high NEWS score. The patient has a history of Type 2 diabetes, hypertension, chronic back pain, and chronic kidney disease stage 3. Would the additional criteria included in NEWS2 be a more applicable tool to assess this patient?

You and your colleague both consider that this patient is triggering for sepsis. What observation may concern you that the patient has progressed from a compensated to a decompensated condition?

What treatment may you want to start managing this patient appropriately?

You attempt to determine the source of infection. What finding is more likely to be indicative of the source of infection?

You suspect a lower respiratory tract infection as the cause, as you auscultate the chest and hear coarse crackles with no other sounds present. Would this patient benefit from nebulisation?

Why may a dry pad with evidence of no urine output for 6 hours cause concern in a sepsis patient (with no signs of retention)?

Sepsis can lead to AKI primarily because it…

With a blood pressure of 86/46, your defibrillator calculates a mean arterial pressure (MAP) of 59 mmHg. What MAP is usually required to maintain renal perfusion?

You have started your fluid bolus to try and correct this and are now ready to transport the patient to hospital. What would be the more appropriate destination?

What blood test parameter is primarily used to assess kidney function on initial presentation to ED?

Approximately how many emergency admissions to hospital have some degree of AKI on further investigation?

In sepsis, the primary cause of hypotension is…

What is included in the ‘Sepsis Six’ protocol that reminds Hospital clinicians of the initial treatment of sepsis?