Acute Medicine11 UKMLA questions
Sepsis — UKMLA Revision Notes
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. It is a medical emergency requiring immediate recognition and treatment. The Sepsis Six bundle, when delivered within one hour, significantly reduces mortality.
Key Facts
- Sepsis-3 definition: life-threatening organ dysfunction caused by dysregulated host response to infection
- SOFA score ≥2 indicates organ dysfunction
- qSOFA: RR ≥22, altered mentation, SBP ≤100 — bedside screening tool
- Septic shock: sepsis + vasopressor requirement + lactate >2 mmol/L
- Mortality: sepsis ~10%, septic shock ~40%
Investigations
- Blood cultures (×2): before antibiotics
- Lactate: >2 mmol/L indicates tissue hypoperfusion
- FBC, U&E, LFTs, CRP, coagulation screen
- Urine dip and culture, CXR
- Source-specific investigations (LP, wound swab, etc.)
Management
- Sepsis Six (within 1 hour): oxygen, blood cultures, IV antibiotics, IV fluids, lactate, urine output
- Broad-spectrum IV antibiotics: within 1 hour of recognition (piperacillin-tazobactam ± gentamicin)
- IV fluid resuscitation: 500ml crystalloid bolus, reassess
- Vasopressors (noradrenaline): if MAP <65 despite fluids
- Source control: drain abscess, remove infected catheter/device
NICE Guideline: NICE NG51 — Sepsis: recognition, diagnosis and early management (2016, updated 2024)
Related UKMLA Conditions
PneumoniaUTIMeningitisCellulitisSeptic Arthritis