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LRTIs and Sepsis

LRTIs and Sepsis. Poppy. Bronchitis/Pneumonia. Bronchitis I nfection & inflammation of airways Pneumonia Infection & inflammation of alveoli. Signs and Symptoms. Signs F ever Tachypnoea Crackles ↓or bronchial breath sounds Symptoms Dyspnoea Cough Sputum Wheeze. Investigations.

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LRTIs and Sepsis

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  1. LRTIs and Sepsis Poppy

  2. Bronchitis/Pneumonia • Bronchitis • Infection & inflammation of airways • Pneumonia • Infection & inflammation of alveoli

  3. Signs and Symptoms • Signs • Fever • Tachypnoea • Crackles • ↓or bronchial breath sounds • Symptoms • Dyspnoea • Cough • Sputum • Wheeze

  4. Investigations • PEFR • Full blood count (↑ WCC) • U&Es • CRP • Lactate • ABGs • CXR • Nose & throat swabs (PCR tests) • Sputum (microscopy, culture & sensitivities)

  5. SEPSIS etc. • SIRS • >1 of : • Temp <36°C or >38°C • HR >90/min • RR >20/min • WCC <4x109/dl or >12x109/dl • SEPSIS • SIRS + known or suspected infection • SEVERE SEPSIS • Sepsis + organ failure • SEPTIC SHOCK • sepsis + hypotension (SBP <90mmHg) despite fluid resuscitation + perfusion abnormalities eg. lactic acidosis, ↓UO, ↓GCS

  6. SEPSIS 6 • Give high-flow oxygen • Take blood cultures • Give empirical IV antibiotics • Measure FBC & serum lactate • Start IV fluid resuscitation • Start accurate urine output measurements

  7. CURB-65 • Confusion • Urea • >7mmol/L • Respiratory rate • >30/minute • Blood pressure • <90mmHg systolic or <60mmHg diastolic • age ≥65 years old • if score >1 → admit & if score >2 → IV treatment

  8. Antibiotics • CAP • Streptococcus pneumoniae • Staphylcoccus aureus • Haemophilusinfluenzae • Amoxicillin/Clarithromycin • HAP • 48-72h after being admitted • Often caused by multiple organisms • Acute bronchitis • Often viral – no antibiotics!

  9. Any questions?

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