QUACK is back! Our team has grown and we are delighted to now deliver medical education regionally across the West of Scotland.
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This week's topic is shock
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Presentation & Guideline
Scoring Systems
Shock
Dr Nick Holt, AIM SpR
Dr Kirsty Crowe, Renal Spr
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Emergency treatment of anaphylactic reactions
Resus Council (2008)
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SIRS Criteria (Septic Inflammatory Response Syndrome)
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SIRS Criteria
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Temperature >38 or <36
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Heart rate >90
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Respiratory rate >20 breaths per min
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White Cell Count >12 or <4
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Sepsis Criteria (SIRS Criteria + ?infection)
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Yes/No
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Severe Sepsis
(Organ dysfunction/hypoperfusion)
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Lactic acidosis
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SBP <90 or SBP drop ≥ 40 mm Hg of normal
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Severe Septic Shock = above not responsive to adequate fluid resuscitation
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qSOFA Quick Sofa Score for Sepsis
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Altered mental status
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Respiratory rate >22
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Systolic BP <100
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A score of 2 or more is assocaited with a 3-14 times increased risk of in-hospital mortality. If so, think about checking a blood lactate level. qSOFA used particularly for predicting mortality.
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PS: Use the scoring systems when concerned about infection, some of the criteria are non-specific
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Figure 1: Resuscitation Council Anaphylaxis Algorithim [ONLINE] Available at: https://www.resus.org.uk/library/additional-guidance/guidance-anaphylaxis/emergency-treatment [Accessed 6 September 2020].
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