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Septic Shock Emergency Nursing

Septic Shock Causes

Septic shock occurs most often in the very old and the very young. It also occurs in people who have other illnesses.

Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungi may cause tissue damage, and may lead to low blood pressure and poor organ function. Some researchers think that blood clots in small arteries cause the lack of blood flow and poor organ function.

The body also produces a strong inflammatory response to the toxins. This inflammation may contribute to organ damage.

Risk factors for septic shock include:
  • Diabetes
  • Diseases of the genitourinary system, biliary system, or intestinal system
  • Diseases that weaken the immune system such as AIDS
  • Indwelling catheters (those that remain in place for extended periods, especially intravenous lines and urinary catheters and plastic and metal stents used for drainage)
  • Leukemia
  • Long-term use of antibiotics
  • Lymphoma
  • Recent infection
  • Recent surgery or medical procedure
  • Recent use of steroid medications
Septic shock is a serious condition that occurs when an overwhelming infection leads to low blood pressure and low blood flow. The brain, heart, kidneys, and liver may not work properly or may fail.

Most common of this case may it’s happened to the patients with Meningococcemia, Waterhouse-Friderichsen syndrome, DIC (disseminated intravascular coagulation), Multiple organ dysfunction syndrome (MODS), Acute Respiratory Distress Syndrome (ARDS).

Septic Shock Symtomps are :
similar to hypovolaemic shock except in the first stages:
  • Pyrexia and fever, or hyperthermia, due to overwhelming bacterial infection.
  • Vasodilation and increased cardiac output due to sepsis.
Therapy are include :
  • Restore intravascular volume via I.V fluid
  • Give supplemental O2 therapy
  • Identify and control source of infection
  • Administer antibiotic
  • Remove risk factor for infection
Septic Shock Treatment

Septic shock is a medical emergency. Patients are usually admitted to the intensive care unit of the hospital.

Treatment may include:

  • Breathing machine (mechanical ventilation)
  • Drugs to treat low blood pressure, infection, or blood clotting
  • Fluids given directly into a vein (intravenously)
  • Oxygen
  • Surgery

There are new drugs that act against the extreme inflammatory response seen in septic shock. These may help limit organ damage.

Hemodynamic monitoring -- the evaluation of the pressures in the heart and lungs -- may be required. This can only be done with special equipment and intensive care nursing.


Septic Shock Emergency Nursing

Always use the ABCDE approach.

Airway
  • Make sure the airway clearance.
  • Give the tool a respirator if necessary (nasopharyngeal).
  • If a decline in respiratory function immediately contact the anesthesiologist and the patient may be brought immediately to the ICU.

Breathing
  • Assess the amount of breathing, more than 24 times / minute is a significant symptom.
  • Assess oxygen saturation.
  • Check arterial blood gases to assess the oxygenation status and the possibility of acidosis.
  • Give 100% oxygen via non re-breath mask.
  • Chest auscultation, to determine the presence of chest infection.
  • Photo thoracic radiograph.

Circulation
  • Assess heart rate, more than 100 times / minute is a significant sign.
  • Monitoring blood pressure.
  • Check the capillary refill time.
  • Attach infusion using a large canul.
  • Replace catheter.
  • Perform a complete blood.
  • Record the temperature.
  • Prepare the urine and sputum examination.

Disability
  • Confused is one of the first signs of sepsis patients, whereas previously there were no problems (healthy and good).
  • Assess level of consciousness

Exposure
  • If the source of infection is unknown, look for the existence of injuries, cuts and the injection site and the source of other infections.
  • Sign of the threat to life.

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