Material Educativo

[Artigo] Sepsis or Septic Shock

Sepsis or Septic Shock

Clinical Description

Care of the emergency department pediatric patient seeking treatment for sepsis or associated septic shock

Key Information

  • Outcomes are improved by early identification of sepsis and the immediate initiation of evidence-based therapy
    following sepsis recognition, including aggressive fluid resuscitation and antimicrobial therapy.
  • Infants and children may be septic without an elevated temperature; a complete history, physical examination
    and clinical judgement are important for early recognition and intervention.
  • Blood pressure alone is not a reliable indicator of successful resuscitation in infants and children. Other
    parameters, such as capillary refill and end-organ perfusion should be evaluated; shock may occur long before
    hypotension occurs.
  • Elevated lactic acid levels may indicate tissue hypoxia and poorer outcomes.
  • ARDS (acute respiratory distress syndrome) is highly associated with sepsis, whether it is the cause or result of
    sepsis. Suspect ARDS (acute respiratory distress syndrome) if PFR (ratio of partial pressure of arterial oxygen
    to fractional inspired oxygen) is less than 300 mmHg.

Threats to Life, Limb or Function

  • acute renal failure
  • ARDS (acute respiratory distress syndrome)
  • DIC (disseminated intravascular coagulation)
  • failure to recognize sepsis
  • multiple-organ-dysfunction syndrome
  • sepsis-associated encephalopathy
  • septic shock

Clinical Goals

By transition of care

A. The patient will demonstrate achievement
of the following goals:

B. Patient, family or significant other will teach
back or demonstrate education topics and points:

  • Goal: Acute Signs/Symptoms are Managed
  • Goal: Acceptable Pain Level Achieved

Correlate Health Status

Correlate health status to:

  • history, comorbidity, congenital anomaly
  • age, developmental level
  • sex, gender identity
  • baseline assessment data
  • physiologic status
  • response to medication and interventions
  • psychosocial status, social determinants of health
  • barriers to accessing care and services
  • child and family/caregiver:
  • health literacy
  • cultural and spiritual preferences
  • safety risks
  • family interaction
  • plan for transition of care

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