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Sepsis: A Systemic Response
Many great historical figures of the scientific community have written on the subject of the same perplexing disease over the centuries (Angus, van der Poll, Finfer, Vincent 2013). Sepsis has been given many names, origins, and etiologies. In the 4th century, Hippocrates declared the disease the cause of organic decomposition, wound festering, and swamp gas (Angus et al. 2013). During the 19th century, Louis Pasteur theorized the disease was the outcome of a pathogenic microorganism in the bloodstream, which resulted in a body-wide infection (Angus et al. 2013). In the 21st century, the medical community made a breakthrough with the discovery of the disease’s link to the inflammatory response system and devised a plan of action to combat the high mortality rates among those infected (Angus et al. 2013). According to Hotchkiss, Monneret, & Payen (2013) the effects of sepsis are well documented, while the molecular processes it utilizes are still being explored; however, new studies are helping to expand our understanding of the centuries old disease.
Etiology
Capriotti & Frizzell (2016) explain that sepsis is often seen in those who have a weak immune system. These individuals are at an increased risk of developing sepsis from microorganisms that a healthy immune system would normally fight off (Capriotti et al. 2016). The elderly, infants, and immunosuppressed patients are the most at risk for developing the condition (Capriotti et al. 2016). Sepsis can be caused by any microbe, but is most often caused by bacteria (Capriotti et al. 2016). Since sepsis has such a broad reach and can develop as a secondary infection after an initial injury or illness, Capriotti & Frizzell (2016) further explain the di...
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...rage 30 years ago of 80% to today’s average of 20-30%.
Conclusion
Research by Hotchkiss, Monneret, & Payen’s (2013) has revealed that sepsis is an immunosuppressive disorder, therefore patients can benefit from immunostimulatory therapies used to treat those who have lowered immune systems. Accordingly, focusing on boosting the immune system has been shown to decrease mortality in patients (Hotchkiss et al. 2013). Hotchkiss et al. (2013) announces that while these statistics are encouraging, the mortality rate is still considered high and further research and techniques are needed in order to continue the downward trend. Hotchkiss et al. (2013) states that it is unclear why some patients survive sepsis and others do not recover. Until the true cause of death in sepsis is understood, the best course of action is prevention, early detection, and immune system support.
BioPatch, and alternatives like Tegaderm CHG, are an important first step in helping prevent catheter-related bloodstream infections (CBIs). As CBIs rank among the most frequent and potentially lethal nosocomial infections, the need for a device to cut down infections at the insertion site has increased. The growing numbers of infections has driven companies to consider a three-tiered approach: a maximal aseptic barrier at insertion, proper site maintenance, and hub protection. With BioPatch and alternative products catheter sites receive that maximal aseptic barrier to prevent bacteria growth.
According to the Clinical Excellence Commission (2014), approximately 6,000 deaths per annum are caused by sepsis in Australia alone. These mortality figures are higher than breast cancer (2,864) and prostate cancer (3,235) combined (Cancer Australia, 2014). Despite advances in modern medicine and increased understanding of the need for timely recognition and intervention (Dellinger et al, 2013), sepsis remains the primary cause of death from infection worldwide (McClelland, 2014). Studies undertaken by The Sepsis Alliance (2014) and Schmidt et al, (2014) state that 40% of patients diagnosed with severe sepsis do not survive.
The guidelines’ first focus is the definition of sepsis, which makes sense, because there is no way to effectively treat sepsis without an accurate and categorical definition of the term. The guidelines define sepsis as “the presence (probable or documented) of infection together with systemic manifestations of infection”. Such systemic manifestations can include fever, tachypnea, AMS, WBC >12k, among others; these manifestations are listed in full in Table 1 of the guidelines. The definition for severe sepsis builds on to the definition of sepsis, bringing organ dysfunction and tissue hypoperfusion (oliguria, hypotension, elevated lactate) into the picture; full diagnostic criteria is listed in Table 2. The guidelines recommend that all
Also, cytokines are used as they can destroy the infection, however there is a problem with this diagnosis as excessive production can cause tissue and organ damage. The pathological physiological outcomes of sepsis is that there is a multi-organ dysfunction that includes the heart, brain, kidneys and the lungs. Acute respiratory distress syndrome (ARDS) is a condition where there is a low oxygen level in the blood, this mostly affects the lungs, people who have sepsis will be affected by ARDS as their breathing rate will decrease. Another reason for multi-organ dysfunction is that there is a lack of blood being given to the organs, this causes low blood pressure or as it’s called hypotension, this mostly affects diabetic people which leads them to having sepsis.
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
“Immune Response: MedlinePlus Medical Encyclopedia.” National Library of Medicine - National Institutes of Health. Web. 18 Dec. 2011. .
Imagine a rare, life-threating complication of a simple bacteria, causing many awful symptoms. One may have bleeding, bruising, diarrhea, and much more – all of which could resemble another aliment. However, with a simple culture that reveals one certain type of bacteria, one may be look at something much more serious. Toxic shock syndrome fittingly earns the name “syndrome” in its title as syndrome refers to “a disease that cause a variety of ailments” (1). As mentioned previously, toxic shock syndrome does just that. It may present itself with common symptoms, but a culture will reveal much more. Specifically, a culture will reveal the unnerving bacteria of none other than either Staphylococcus aureus or Streptococcus pyogens. Both of these bacterium cause what is known as toxic shock syndrome with the only difference in being their initial symptoms. Toxic shock syndrome has been documented to have been first recorded by the Greek physician Hippocrates who lived about 460-377 B.C. (1). However, toxic shock syndrome was questioned and remained a mystery for hundreds of years later. Toxic shock syndrome was thought to be “an obscure disease limited to a particular population of people in which the disease predictably appeared” (1). In the 1900s, toxic shock syndrome became a disease associated with trauma. This trauma may have been from car accidents, industrial mishaps, or even war injuries, but no one person could figure it out entirely. Annually, toxic shock syndrome affects _____.
Vorvick, Linda, Jatin Vyas and David Zieve. "Gangrene." 24 August 2011. MedLine Plus. 20 November 2013 .
The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
In patients infected with K. pneumonia, inflammatory mechanisms can cause tissue damage that is related with a release of “alarm proteins” (Achouiti, 2012). These alarm proteins are known as the Damage Associated Molecular Patters (DAMPs) and are seen in neutrophils where they potentially affect up to 45 percent of the cytoplasmic protein (Achouiti, 2012). This is harmful because it inhibits the body’s ability to fight the infection, as neutrophils are the body’s natural immunity defense.
...f infections acquired during the hospital. Many of these studies have indicated that these infection control interventions will decrease the number of sick or dying patients related to hospital acquired infections and lower the medical cost by decreasing the stay of each patient in the hospital.
“ Sepsis” according to the International Surviving Sepsis Campaign, is defined as the presence of infection together with systemic manifestations of infection (Dellinger et al., 2013) In todays modern society sepsis still accounts for 15% of maternal deaths a year worldwide (Dolea & Stein, 2003). Despite medical advances, aseptic technique, and antibiotic use, sepsis is the most common cause of direct maternal death in the UK. According to the CMACE report the maternal mortality rate increased from 0.85 deaths per 100,000 maternities in 2003–05 to 1.13 deaths in 2006–08 (Harper, 2011). Puerperal sepsis has a long history within obstetrics and midwifery, and yet despite this knowledge it has become, yet again, the leading cause of direct maternal death. Therefore due to the increased maternal mortality, I have chosen to focus on the care of a woman within ...
Our body has its own defense system and it fights and battles to protect us from infections and injuries. Inflammation is one of those defense responses, and while it doesn’t give you a great feeling, it does tell you that your body is sending nutrients and immune cells to an area of your body in need.