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So I want to talk today about about sepsis. This so sent us. This particularly important, especially in the any department we want to try and recognizing. Relate. We have a good opportunity then and am going to try and get on top of things. So what is sepsis? Sepsis is defined as a distributive response to an infection, which then results of life threatening organ dysfunction so you can detect this organ dysfunction clinically added. By seeing someone in front of you with very high. It's pretty obvious, and we're dropping helps 10 cents, or also by using lab results so they could be the only side of peanut or having a K I. So there's quite a big burden on the health service every year. So just under $250 in cases of sepsis or diagnosed each year in the UK I know if those 250,000 just lasts and 50,000 patients will and die because of us. So looking at the actual death tool when you had together brand spoiled prostate cancer, those three combined are still less than the total that's for sexist. So she was your high big, um it a player it is I'm on. And that's really why it's important to try and recognize it early. I'm trying. Get in with management as soon as possible. The risk factors and one of the medium risk factors is aged, so if you're over 65 you're 13 times more likely. Develop a subsistence someone under this age. It's also important to think of it in patients here. Um, I'll nourished those a chronic illness, diabetes, heart disease, someone who's knows to transform specific medications. If someone's had recent surgery, or if they have in billing catheters and or other devices that would be conservative and just have those sort of things in the back of your mind. Someone comes in on well looking, then at the actual definition. So there's a few different ways you can define sepsis. We can use the systemic inflammatory response syndrome and your surge. So what you're looking for in that kiss is two more of the following criteria. So a temperature more than 30 it or niacin 36 heart bit greater than 98 or spread rate greater than 20 or white cells greater than 12 or lasting four and so if you see someone with two or more, they used to have to think about your head. Okay, could that be set that on? It's particularly important as well, because three of these criteria can be picked up early on a triage. So although we may not know their white cells at that point, we could still have a rough idea. The little people could be set, but so that'll that definition and is serves, plus a source off suspected infection. Not at that stage said the mortality is about 20%. If we then don't deceptive stroke mortality jumps again higher to greater than 40%. So it is very important to get these people treated before they spiral guide. Antiseptic shop to it is defined a sepsis plus hypertension, requiring these oppressors on a lactic. It's greater than two, despite adequate sleep resource. Another way that you could look it. Sepsis is using the Q so four quick sequential organs in your assessment score. It's a lot quicker and on. It's just if you're seeing some of the bad site, you can quickly do this test, so there's three criteria. It's positive if you meet to your thumb. So respiratory it off. 22 you're more older. DCs from baseline or a PSA starts just a solid BP of last 100. We can also look at our new start on the body when you start to have a trigger. I am. It's to say if someone sporting three and normal prouder more than five or they've changed quickly to think about possible in front of sorts is around. So just another way to think about it. So what can we do? The most important thing is probably recognize patients that are at risk early and as soon as they come in to the department. If they get a full set of obese and we can check, is the mental state changed? Um, is there something there that could suggest they are separate on then, most importantly is they treat them with our sense to six within and are looking on to the department. So Aricept six in and we want to give three things. You want to take three things so oxygenatum anti and socks over 94. Or if there are new one, take the Risperdal rate. Bigger idiot to meet you, too. Blood culture standing. This sent off antibiotics going to China with the death ones later on in the presentation. Want to give a flea a challenge? Bearing in mind, obviously, if someone has heart failure or if a particularly smaller elderly taking that into consideration as well. But if they're able to give him a good, decent food challenges, well blacked it is also should be particularly important and predicting more better the immortality. So take a lot It on then measure your like put doesn't necessarily mean putting a catheter and everybody. But if they compete, measure what they're peeing on. But you could maybe use a condom or a catheter if we need to. So then on the building. Joyce is for the Northern Health and Social Care Trust. This is taken from the treatment guidelines out, which is specific for your trust. So sections of unknown origin you could go towns and gent plus take if they're know MRSA Choir or there's an alternative regime for penicillin Allergy on then it had been accepts is something always think about is well, that's just the reason that you would use for them So 1000 gent and consider take or Cipro gentle. Take if I ever someone comes in and they have a clear source, such as a chance infection or a UTI. Don't. We're doing the Taj. It's our the sex of unknown origin. Treat them as to what they should be treated by if by that stage we don't know when it's coming up and they are, we can treat them. But it's better to treat them accordingly if they have a normal source. So our, um then is really to try and restore tissue profusion of anti an oxygenation to your tissues? Prevent further damage McCurry on by some time to try and find the source of infection on. Ultimately then treat the underlying cause. I was saying about a locked it being particularly important, so studies have shown that lactate great ovens. Where is associate with that Really bad I come, but taking acting it's an elective. Responding to treatment is showing to be a beneficial thing. So if we get one initial active and it's high, always try and take it after they've had a flu booster after the past, some form of treatment. If the left it isn't responding, we may need to think we doing in us? This is the side note there on your skin, except this. So your opinion is defined as having it fills last one, irrespective of our total white cell count. And we most commonly associated with Kim affair. Um, especially having about your mind about if someone's had chemo within the last six weeks. But it's not only with patients on chemotherapy thing about patients. He have a plastic anemia, autoimmune diseases, except for on other medications that may cause it the treatments we have already discussed. So it's blowing our local on the guidelines on treatment guidelines on There's also a really good protocol on the Internet as well. Just going through that accepts is on patients that may need to be admitted. Or that was, it could be see if they sent home if they made a lot this specific criteria, man just going through and then the me and take home points. It was your reception. Six. So with a high flow oxygen, blood cultures, antibiotics cleared, challenge black tea it on, then keeping an eye on your right foot, bearing in mind that not all patients will present with the classical symptoms. Um especially in elderly population. You may need to think if someone's come in for the full on their DCs is a bit off their spring. It's that high. They may not just be a consequence high temp, no BP. So it's important to go through the different and different prominent on see if their score and then obviously getting treatment done and within an R. So those are my references. Any questions? Look, really thinks much did, and we'll give you a good chance. That question about they have any on. But we couldn't they, uh, recent stay with They told me samples, Yeah.