Septic Shock

Presented By
Shini Sebastian
 What’s Septic Shock ?

Septic shock is a serious medical condition that

occurs when sepsis, which is organ injury or
damage in response to infection, leads to
dangerously low blood pressure and
abnormalities in cellular metabolism .It can be
very dangerous and potentially life-
threatening.
Stages of Septic Shock
 Causes ?
A bacterial, fungal, or viral infection can cause
sepsis.

• Sepsis commonly originates from:

• Abdominal or digestive system infections

• Lung infections like pneumonia
• Urinary tract infection
• Reproductive system infection
 Risk Factors

• Major surgery or long-term hospitalization

• Hospitalized patients that are already very sick

• Exposure to devices like intravenous

catheters, urinary catheters, or breathing tubes,
which can introduce bacteria into the body

• Poor nutrition
 Lets watch this

Septic Shock explained- Video

 Signs & Symptoms
Red flag findings — Red flag findings that should prompt rapid clinical assessment
and resuscitation for severe sepsis or septic shock include

1) Presence of fever
2) Hypothermia
3) Tachycardia
4) Tachypnea
5) Abnormal pulse (diminished, weak, or bounding)
6) Abnormal capillary refill (central refill ≥3 seconds or flash refill [<1 second])
7) Hypotensive
8) Abnormal mental status:
i. Irritability
ii. Inappropriate crying
iii. Inappropriate drowsiness (eg, excessive per caregiver)
iv. Not interacting with caregiver
v. Difficult to arouse (lethargic or obtunded)
vi. Confused (not oriented to person, place, or time when developmentally
appropriate to test)
 Signs & Symptoms…….
• Toxic or ill appearance
●Signs of dehydration
●Rigors
●Decreased tone in neonates and infants
●Seizures
●Meningismus
●Respiratory depression or failure
●Pulmonary rales or decreased breath sounds caused by bronchopneumonia
●Distended, tender abdomen (eg, perforated viscus or intraabdominal abscess)
●Costovertebral angle tenderness (eg, pyelonephritis)
●Macular erythema (toxic shock syndrome)
●Skin cellulitis, lymphangitis, or abscess
●Warmth, swelling, and/or erythema of an extremity or joint suggestive of
osteomyelitis and/or septic arthritis
●Peripheral edema caused by capillary leak
●Multiple nodules which can be seen with disseminated S. aureus or fungal
infections
●Ecthyma associated with Pseudomonas infection
●Purpura anywhere on the body or petechiae below the nipple line
PATHOPHYSIOLOGY
How infective material work ?

• Tissue perfusion
• Hypotension
• DIC ( Disseminated Intra Vascular Coagulation)
• ARDS
• Cardiac Output
 Investigation
• Basic blood test; CBC, LFT, coagulation, glucose
• Inflammatory markers; PCT, CRP
• ACID BASE STATUS
• VENOUS OR ARTERIAL GASES
• LACTATE
• BASE DEFICIT
• SEPTIC WORK UP
• BLOOD ,URINE AND SPUTUM CULTURE
• Viral culture throat ,NPA, faeces
• IMAGING
• X-RAY ,MRI,PET SCAN,ECHO,ULTRSOUND.
Treatment
Complications
 Complications….

• Heart failure
• Abnormal blood clotting
• Kidney failure
• Respiratory failure
• Stroke
• Liver failure
• Loss of a portion of the bowel
• Loss of portions of the extremities
 Nursing Management
1.Ineffective Tissue Perfusion related to progression of
septic shock with decreased cardiac output,
hypotension, and massive vasodilatation
2. Ineffective Breathing Pattern related to rapid
respirations and progression of septic shock
3.Risk for fluid and electrolyte imbalance related to
vasodilation
4.Hyperthermia / Hypothermia related to an increase in
metabolic rate, vasoconstriction / vasodilation of blood
 Characteristics of Septic Shock
1. Systemic vasodilation & Hypotension
2. Tachycardia , depressed contractility
3. Vascular leakage and Oedema, Hypovolemic
4. Compromised nutrient blood flow to organ
5. abnormal blood gases & acidosis
6. Respiratory distress & multiple organ failure