Sepsis

Exam Cram

• Sepsis is a poorly defined term, loosely referred to as a severe infection which causes bodily dysfunction via its activation of the immune system, 

• Sepsis can reasonably be thought of as a bacteraemia + SIRS (systemic inflammatory response syndrome), although this is a historical schema

• Sepsis is associated with increased mortality

• Management of sepsis is centered around IV antibiotics, IVF and monitoring of BP, which dictate discussions around goals of treatment & location of care (ward, HDU, ICU, comfort)

Definitions

• Bacteremia: Bacteria in blood

• Septicemia: "sepsis" in blood, old term not used

• Sepsis: Severe infection causing bodily dysfunction via immune system activation

• SIRS: Systemic inflammatory response syndrome- attempting to describe the associated immune system activation 

Severity

Sepsis usually results in death via septic shock and an inability to maintain BP. Hence these scores focus on BP:

• SIRS criteria: temperature > 38 or < 36, HR > 90, RR > 20, WCC > 12 or < 4

• Organ hypoperfusion: raisd lactate, SBP < 90 or SBP > 40 from baseline

• Septic shock: MAP < 65 despite adequate IVF

• Multiorgan failure: evidence of > 1 organ failing 

• qSOFA: RR > 22, GCS < 15, SBP < 100 [predicts mortality]

Page written in 2026.