Sepsis Z. Rozkydal •Sepsis is a systemic reaction to the infection • •Site of infection •Bacteriemia •Local sings of infection •Systemic signs of infection • •Sepsis • •Immunodeficiency •Diabetes mellitus •Liver cirrhosis •Immunosupresivs, corticoids, chemotherapy • • •G- bacteria • •Mortality in septic shock 25-60 % •Signs • •Local : rubor, calor, dolor, tumor, functio laesa • fistula, discharge • •Systemic: •Fever (septic fever- difference 2˚ C) •Wekness, fatique •Shivering, sweating, tachypnoe, tachycardia •Nausea, vomiting, stomach pain •Septic shock • •Tachycardia, hypotensis •Flat breath •Pale periphery, acrocyanosis •ARDS •Circulatory failure •Disorder in consciousness • •First aid •Basic principles, transport • •Management •Drips, ventilation •Antibiotics •Noradrenalin, dopamin •Surgery: Ubi pus, ibi evacua Allergy •Allergy = high sensitivity • •Specific reaction of allergic substance to •antibodies (Ig E) or to sensibilisated lymphocytes • •Release of histamin, serotonin, leucotrien • •It occur´s in repeated exposure to the same •substance •Symptoms • •1/ Vasodilatation •Local- erythema, papula (pimple) •Systemic- circulatory fluid into the periphery •- hypotensis, failure of circulatory system • •2/ Bronchi •Contractures of muscles – bronchospasmus •High secretion of fluid in airways- bronchi •Obstruction in airways, caugh, dyspnoe, choking, •cyanosis •Higher motility in GIT, spasm in the abdomen •Anaphylactic shock • •Acute systemic reaction to foreign substance, •which organism met in the past time • •Allergic substanses: proteins of serum, •blood products, coloids, antibiotics, food, •sting from bee or wasp, herbs, flowers • •Senzibilisated person •Symptoms • •Flash in the face, caugh, dyspnoe, •choking, bronchospasm, laryngospasm •tachycardia, hypotensis •nausea, vomiting •shock, unconsciousness •Insect sting •Bee, wasp, hornet • •Pain at the site of the sting •Redness and swelling •In the mounth- swelling of tissues •- blocked airways •Flash in the face, caugh, dyspnoe, •choking, bronchospasm, laryngospasm •tachycardia, hypotensis •nausea, vomiting •shock, unconsciousness •First aid- insect sting • •Ice cube to suck, cold water, •Cold compress-ice pack •Raising the affecting part •Free airways, oxygen •Adrenalin 0,5 – 1,0 ml s.c. or slowly i.v. •Inhalation of adrenalin •Aminophylin in bronchospasm •Noradrenalin- in systemic vasodilatation •Glucocorticoids in spray or i.v. •