ABCDE Assessment for Septic Shock

Septic shock is a serious condition as a result of severe infection and sepsis, though the microbe may be systemic or localized to a particular site. It can cause a dramatic drop in blood pressure, preventing the delivery of blood to the organs. Septic shock can lead to multiple organ failure including respiratory failure, and may cause rapid death. Toxic shock syndrome is one type of septic shock.

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 usually preceded by bacteremia, which is marked by fever, malaise, chills, and nausea. The first sign of shock is often confusion and decreased consciousness. In this beginning stage, the extremities are usually warm. Later, they become cool, pale, and bluish. Fever may give way to lower than normal temperatures later on in sepsis.

Other symptoms include:
  • rapid heartbeat
  • shallow, rapid breathing
  • decreased urination.
  • reddish patches in the skin

Septic shock may progress to cause "adult respiratory distress syndrome," in which fluid collects in the lungs, and breathing becomes very shallow and labored. This condition may lead to ventilatory collapse, in which the patient can no longer breathe adequately without assistance.


ABCDE Assessment for Septic Shock

Airway
  • Assure effective airway
  • Give a ventilator if necessary (Guedel or nasopharyngeal)
  • If a decline in respiratory function immediately contact an anesthesiologist and take it as soon as possible to the ICU.

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

Circulation
  • Assess heart rate> 100 beats per minute is a significant sign.
  • Monitoring of blood pressure.
  • Check the capillary refill time.
  • Attach infusion using a large canul.
  • Give fluids.
  • Insert the catheter.
  • Perform complete blood count.
  • Prepare for culture.
  • Record the temperature, the possibility of patients pyrexia or temperature of less than 36oC.
  • Prepare urine and sputum.
  • Give broad spectrum antibiotics according to local policies.

Disability
  • Confused is one of the first signs of sepsis patients where previously no problems (healthy and good).
  • Assess level of consciousness using AVPU.

Exposure
  • If the source of infection is unknown, looking for any injury, cuts and the injection site and the source of other infections.

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