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Sepsis: Blood and Fluid Resuscitation

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Sepsis: Blood and Fluid Resuscitation
Sepsis; pathophysiology, etiology and treatment Abstract

To define the disease known as sepsis, briefly discuss its pathophysiology, etiology, signs, symptoms, and treatments. Outline protocols for sepsis screening, early directed goal therapy, and to establish the nurse’s role in the process. Sepsis is a complex disease, or response to a disease process that can lead to patient mortality rates up to 60%. Gram negative infectious organisms invade the blood stream, and activate a systemic response. This systemic response exacerbates the problem, leading to disproportionate blood flow, alterations in tissue perfusion, and eventually multiple organ failure. Sepsis screening begins in the ER, signs and symptoms that are indicative of sepsis, or early indications of infection that can eventually lead to sepsis should be identified quickly. Since the majority of these patients are already compromised, it is imperative to have proper screening and initiate early goal directed therapy. Following standard protocols has proven to reduce mortality rates by as much as 25%.
Sepsis; pathophysiology, etiology and treatment
Sepsis has been defined as a suspected or proven infection that has entered the blood stream, and has the clinical manifestations of what has been termed the systemic inflammatory response (e.g., fever, tachycardia, hypotension, and elevated white blood cell count termed leukocytosis) (Dellacroce, 2009, p. 17). Sepsis can be a result of any infection in the body that has triggered this systemic inflammatory response. Often times especially in the elderly it might be a result of an untreated urinary tract infection, or some other unknown infection that enters into the blood stream. When the invading organism or antigen enters the bloodstream, it releases endotoxins, a toxic substance usually associated with gram negative bacteria, such as Escherichia coli, Klebsiella pneumoniae, Serratia, Enterobactor, and Pseudomonas. In the patient who is ill



References: Dellacroce, H. (2009, July). Surviving sepsis: The role of the nurse. RN, 16-21. Gerber, K. (2010). Surviving sepsis: a trust-wide approach. A Multi-disciplinary team approach to implementing evidence-based guidelines. British Association of Critical Care Nurses, Nursing in Critical Care 2010, 15, 141-151. Porth, C. M. (2011). Essentials of Pathophysiology (3rd ed.). Philadephia, PA: Lippincott Williams & Wilkins. Severe Sepsis/Septic Shock Screening Checklist for Early Goal Directed Therapy [Protocol]. (2011). LRMC Soo Hoo, W. F., Muehlberg, K., Ferraro, R., & Jumaoas, M. C. (2009, July 4). Successes and Lessons Learned Implementing the Sepsis Bundle. Journal of Healthcare Quality, 31(9-15).

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