Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

of

Sepsis  scoring Slide 1 Sepsis  scoring Slide 2 Sepsis  scoring Slide 3 Sepsis  scoring Slide 4 Sepsis  scoring Slide 5 Sepsis  scoring Slide 6 Sepsis  scoring Slide 7 Sepsis  scoring Slide 8 Sepsis  scoring Slide 9 Sepsis  scoring Slide 10 Sepsis  scoring Slide 11 Sepsis  scoring Slide 12 Sepsis  scoring Slide 13 Sepsis  scoring Slide 14 Sepsis  scoring Slide 15 Sepsis  scoring Slide 16 Sepsis  scoring Slide 17 Sepsis  scoring Slide 18 Sepsis  scoring Slide 19 Sepsis  scoring Slide 20 Sepsis  scoring Slide 21 Sepsis  scoring Slide 22 Sepsis  scoring Slide 23 Sepsis  scoring Slide 24 Sepsis  scoring Slide 25
Upcoming SlideShare
What to Upload to SlideShare
Next
Download to read offline and view in fullscreen.

0 Likes

Share

Download to read offline

Sepsis scoring

Download to read offline

KAMRAN YOUSAF
FCPS,MRCS
MEEQAT HOSPITAL MADINA MUNAWARA

  • Be the first to like this

Sepsis scoring

  1. 1. SEPSIS SCORING KAMRAN YOUSAF FCPS,MRCS MEEQAT HOSPITAL MADINA MUNAWARA
  2. 2.  INTERNATIONAL CONSENSUS ON SEPSIS AND SEPTIC SHOCK,,,,,1991 TO 2001 AND 2004  2004 THROUGH 2008 SURVIVING SEPSIS CAMPAIGN,SSC  THIRD INTERNATIONAL CONSENSUS ON SEPSIS ,,,2016  HOUR-1 UPDATE 2018 HISTORICAL PERSPECTIVE
  3. 3.  AFFECTS MILLIONS AROUND THE GLOBE  LOADS OF STUDIES ON EPIDEMIOLOGY,,,SIMPLE EQUATION IS THAT THE DISEASE HAS RISEN FROM THOUSANDS PER YEAR IN MAJOR CLINICAL SETTINGS TO OVER A MILLION AND A HALF PER YEAR IN THE LAST 40- 50 YEARS.  ECONOMIC BURDEN,,,20 BILLION USD IN US AND KSA ???  MAJOR CAUSE OF MORTALITY,,,30-50 % FOR SEP SHOCK AND 20-30 % FOR SEPSIS MAJOR HEALTH CARE ISSUE
  4. 4.  ITS AS IMPORTANT AS A CASE OF POLYTRAUMA IN ER  OR A CASE OF ACUTE MI  OR A PATIENT WITH STROKE ACUTE MD EMERGENCY,,,,,,PARAMOUNT IMP MAGNITUDE OF PROBLEM
  5. 5.  PRIMARY CAUSE OF DEATH FROM INFECTION ESP IF NOT RECOGNISED EARLY  A SYNDROME SHAPED BY PATHOGEN FACTOR AND HOST FACTOR  SEPSIS INDUCED ORGAN DYSFUNCTION MAY BE OCCULT,,,  UNEXPLAINED ORGAN DYSFUNCTION----UNDERLYING SEPSIS KEY CONCEPTS OF SEPSIS
  6. 6.  SITE OF INFECTION,,,,,,,,RTI 44-60 %  ,,,ABDOMEN 26%  ,,,BLOODSTREAM 20%  ,,,URIN SYSTEM 12-20 %  ,,,,SKIN/SOFT TISSUE 14%  NO DEFINITE SOURCE IN 20-30 % KEY CONCEPTS
  7. 7.  GRAM POITIVE REMAIN THE MOST FREQUENT  GRAM NEGATIVE SUBSTANTIAL  FUNGAL SEPSIS IS ON THE RISE BUT REMAINS LOWER THAN THE BACTERIAL  IN ALMOST HALF THE CASES NO PATHOGEN IS IDENTIFIED (CULTURE NEGATIVE SEPSIS) THE PATHOGENS
  8. 8.  PATHOGEN VARY,,,REGION,HOSPITAL SIZE,SEASON,TYPE OF UNIT ETC  90 % OF IDENTIFIED PTHOGENS ARE GRAM POSITIVE AND NEGATIVE  SINCE MID 80’S,,,G POS SURPASED THE G NEG SEPSIS  G POS CN STAPH AUREUS,ENTERO,STREP  G NEG E COLI,KLEB PNEUM,PSEUDOM  E COLI REMIANS THE MOST PREVLANT SINGLE PATHOGEN PATHOGENS,,,CONT-D
  9. 9.  INCIDENCE,,,,,EVER RISING NO OF PATIENTS  HOSPITALIZATION,,,BED OCCUPANCY BY SEPSIS RELATED PTIENTS HAS RISEN SHARPLY  COST/ECONOMIC BURDEN,,,HEFY AMOUNT OF MONEY AND HUMAN RESOURCES BEING SPENT ON THEM  MORTALITY,,,,ONE OF EVERY FOUR PATIENTS WILL DIE ENOUPH???
  10. 10.  SEPSIS HAS BEEN REDEFINED AS LIFE-THREATENING ORGAN DYSFUNCTION CAUSED BY A DYSREGULATED HOST RESPONSE TO A NEW INFECTION.  SEPTIC SHOCK HAS ALSO BEEN REDEFINED AS A SUBSET OF SEPSIS IN WHICH PARTICULARLY PROFOUND CIRCULATORY, CELLULAR, AND METABOLIC ABNORMALITIES ARE ASSOCIATED WITH A GREATER RISK OF MORTALITY THAN WITH SEPSIS ALONE NEW DEFINITIONS
  11. 11. PREDICT ORGAN DYSFUNCTION AND MORTALITY BETTER WHY SCRING SYSTEMS ?
  12. 12. WHICH SCORING SYTEM?
  13. 13. • "THE SOFA SCORE FOUND PATIENTS MORE LIKELY TO BE SEPTIC BOTH IN AND OUT OF THE ICU. BUT IT INVOLVES THE USE OF MANY LAB TESTS AND IS A BIT COMPLEX. • FOR PATIENTS NOT IN THE ICU, THE PERFORMANCE OF QUICK SOFA SCORE WAS SIMILAR TO THAT OF THE SEQUENTIAL ORGAN FAILURE ASSESSMENT SCORE. CHOOSING THE SCORING SYATEM
  14. 14.  IN THE OLD CRITERIA FOR SEPSIS, SIRS SCORE WAS A MEASURE OF RESPIRATORY RATE, WHITE BLOOD CELL COUNT, HEART RATE, AND FEVER. • THE SEQUENTIAL ORGAN FAILURE ASSESSMENT SCORE( SOFA ) AND THE LOGISTIC ORGAN DYSFUNCTION SYSTEM SCORE ( LODS ) ARE MORE RECENT ,PREDICT ORGAN DYSFUNCTION AND MORTALITY BETTER
  15. 15. MODIFIED VERSION OF SOFA, BEDSIDE WITH QSOFA, ▫ RESPIRATORY RATE ≥22/MIN ▫ ALTERED MENTATION ▫ SYSTOLIC BLOOD PRESSURE ≤ 100MMHG THE PRESENCE OF AT LEAST TWO OF THESE CRITERIA STRONGLY PREDICTS THE LIKELIHOOD OF POOR OUTCOME IN OUT-OF-ICU PATIENTS WITH CLINICAL SUSPICION OF SEPSIS. IDENTIFICATION OF EARLY SEPSIS QSOFA
  16. 16.  HITORIC,,,,,,SIRS  Q SOFA  TRACT AND TRIGGER WARNING SCORE,,,MEWS SCORING SYSTEM THE SCREENING PROMPTS
  17. 17. SIRS IS STILL RELEVANT?  IT HELP IDENTIFY THE SOURCE OF INFECTION  PRESENCE OF 2 SIRS CRITERIA WILL DIG OUT THE UNCOMPLICATED SEPSIS
  18. 18.  SIRS  Q SOFA  MEWS  NEWS (UK) HISTORIC SCORING LADDER
  19. 19.  SEPSIS  SEPSIS BUNDLES AND SSC  SEPTIC SHOCK  SIRS  SCREENING PROMPTS,,,SCORING SYSTEMS  RED FLAG SEPSIS  AMBER FLAG SEPSIS TERMINOLOGY
  20. 20. Thank you

KAMRAN YOUSAF FCPS,MRCS MEEQAT HOSPITAL MADINA MUNAWARA

Views

Total views

92

On Slideshare

0

From embeds

0

Number of embeds

0

Actions

Downloads

7

Shares

0

Comments

0

Likes

0

×