Tag Archives: Sepsis and C. diff.

“Sepsis Knows No Boundaries; It Can Happen To Anyone” Discussed on C. diff. Spores and More With Guests Carl Flatley,DDS, Sherrie Dornberger,RN, and Hudson Garrett, Jr, PhD

 

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C. diff. Spores and More,” Global Broadcasting Network – innovative and educational interactive healthcare talk radio program discusses

This week’s episode——

“Sepsis Knows No Boundaries; It Can Happen To Anyone”

TO DOWNLOAD AN INFORMATION GUIDE, COURTESY OF SEPSIS ALLIANCE, PLEASE

CLICK ON THE LINK BELOW:

http://www.sepsis.org/files/sig_sepsisandcdifficile.pdf

Our Guests:

Dr. Carl Flatley, DDS, MSD

Sherrie Dornberger, RN,CDONA, GDCN, CDP, CADDCT, FACDONA
Clinician and Sepsis Survivor

Dr. Hudson Garrett, Jr. PhD, MSN, MPH, FNP, CSRN, VA-BC, CDONA,FACONA,DON-CLTC™ , C-NAC™ , PLNC

 

In this episode Sepsis will be defined by three Healthcare Clinicians and one Clinician — a Sepsis survivor.  According to the CDC’s National Center for Health Statistics estimates that, based upon information collected for billing purposes, the number of times people were in the hospital with sepsis or septicemia (another word for sepsis) increased from 621,000 in the year 2000 to 1,141,000 in 2008. Between 28 and 50 percent of people who get sepsis die.

Sepsis is a potentially life-threatening complication of an infection.  If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death. Anyone can develop sepsis, but it’s most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis improves chances for survival.

MORE ABOUT OUR GUESTS:

Carl Flatley, DDS, MSD
On April 30, 2002, Carl Flatley’s life changed. It was the day his daughter
Erin died from Septic shock, something Dr. Flatley, a retired Endodontist,had never heard of.
After Erin’s death, Dr. Flatley learned everything he could about sepsis and he was
astounded at what he – and millions of other Americans – didn’t know about the condition.
He was shocked to learn that sepsis killed well over 200,000 people in the U.S. every year
and affected so many more survivors. In 2004, Dr. Flatley founded the American Sepsis Alliance,which in 2007,became Sepsis Alliance. He made it his mission that sepsis would become as well  known as cancer, diabetes, and other illnesses, and that as few people as possible would  get sepsis, let alone die from it. His unending devotion to Erin’s memory has had a  significant impact on many people.

Sherrie Dornberger, RN,CDONA, GDCN, CDP, CADDCT, FACDONA
Clinician and Sepsis Survivor
NADONA/LTC is a Nurse specialty organization representing the nurse leaders within the long term care continuum association with a mission to support and promote quality of care for those individuals receiving long term care, and concern for those delivering long term care. NADONA/LTC has nominated Sherrie Dornberger as their designated representative. Sherrie is the current Executive Director of NADONA/LTC, and is a Registered Nurse with 40+ years of experience in Nursing Administration, Long Term Care, and Infection Prevention.

Hudson Garrett, Jr. PhD, MSN, MPH, FNP, CSRN, VA-BC, CDONA,FACONA,DON-CLTC™ , C-NAC™ , PLNC
Dr. Garrett is a recognized international expert in infection prevention and control.
Dr Garrett currently serves as the Chairperson of the Education Committee for the
C Diff Foundation, and Vice President, Clinical Affairs PDI, Inc. and is a graduate of the
Johns Hopkins Fellows Program in Infection Control and Hospital Epidemiology. He was honored  as a Who’s Who for Infection Control by Infection Control Today Magazine in 2013 in recognition of his contributions to the field.

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C. diff. Spores and More ™“ Global Broadcasting Network spotlights world renowned topic experts, research scientists, healthcare professionals, organization representatives,C. diff. survivors, board members, and their volunteers who are all creating positive changes in the
C. diff.
community and more.

Through their interviews, the C Diff Foundation mission will connect, educate, and empower many worldwide.

Questions received through the show page portal will be reviewed and addressed  by the show’s Medical Correspondent, Dr. Fred Zar, MD, FACP,  Dr. Fred Zar is a Professor of Clinical Medicine, Vice HeZarPhotoWebsiteTop (2)ad for Education in the Department of Medicine, and Program Director of the Internal Medicine Residency at the University of Illinois at Chicago.  Over the last two decades he has been a pioneer in the study of the treatment of
Clostridium difficile disease and the need to stratify patients by disease severity.

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C. diff. Infection (CDI) and Sepsis

What is Sepsis?

Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.  If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death.

Anyone can develop sepsis, but it’s most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.

Definition of Sepsis:  sep•sis (ˈsep-səs) n. Sometimes called blood poisoning, sepsis is the body’s often deadly response to infection.

Patients are given a diagnosis of sepsis when they develop clinical signs of infections or systemic inflammation; sepsis is not diagnosed based on the location of the infection or by the name of the causative micro-organism. Physicians draw from a list of signs and symptoms in order to make a diagnosis of sepsis, including abnormalities of body temperature, heart rate, respiratory rate, and white blood cell count. Sepsis may be diagnosed in a 72-year-old man with pneumonia,, fever, and a high white blood cell count, and in a 3-month-old with appendicitis, low body temperature, and a low white blood cell count.

What causes Sepsis?

Sepsis is a response to an infection. When you get an infection, your immune system releases chemicals into your blood to fight the infection. The chemicals sometimes cause body-wide inflammation, which can lead to blood clots and leaky blood vessels. This impairs blood flow, which damages the body’s organs by depriving them of nutrients and oxygen.

Different types of infections can lead to sepsis, including infections of the skin, lungs, urinary tract, abdomen (such as appendicitis), or other part of the body. Healthcare-associated infections (HAI’s), including pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and surgical site infections can sometimes lead to sepsis. MRSA infections of the skin and soft tissue can also lead to sepsis.

Sepsis infected blood cell

 TO DOWNLOAD A “SEPSIS AND C. difficile” Information guide, courtesy of Sepsis Alliance, CLICK ON THE FOLLOWING LINK:

http://www.sepsis.org/files/sig_sepsisandcdifficile.pdf

 

Who gets Sepsis?

Anyone can get sepsis, but the risk is higher in:

  • people with weakened immune systems
  • infants and children
  • elderly people
  • people with chronic illnesses, such as diabetes, AIDS, cancer, and kidney or liver disease
  • people suffering from a severe burn or physical trauma

How many people are diagnosed with Sepsis?

According to the CDC’s National Center for Health Statistics estimates that, based upon information collected for billing purposes, the number of times people were in the hospital with sepsis or septicemia (another word for sepsis) increased from 621,000 in the year 2000 to 1,141,000 in 2008.1  Between 28 and 50 percent of people who get sepsis die.2

The number of cases of sepsis each year has been going up in the United States.  This could be because of the following reasons:   the population is aging, people have more chronic illnesses, people are getting more invasive procedures, immunosuppressive drugs, chemotherapy, and organ transplants;  increasing antibiotic resistance,  increasing awareness and tracking of sepsis

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For Healthcare Professionals: Use this optional tool to screen patients for severe sepsis in the emergency department, on the medical/surgical floors, or in the ICU http://survivingsepsis.org/SiteCollectionDocuments/ScreeningTool.pdf

 

Recommendations: Special Considerations in Pediatrics*

 

 http://survivingsepsis.org/Guidelines/Documents/Pediatric%20table.pdf

 

4. Clostridium difficile colitis should be treated with enteral antibiotics if tolerated. Oral
vancomycin is preferred for severe disease (grade1A).
Sepsis Pocket Card for Healthcare Professionals:
Surviving Sepsis Campaign Bundle
Initial Resuscitation Bundle
To Be Completed in 3 hours:
1)Measure lactate level
2)Obtain cultures prior to administration of antibiotics
3)Administer broad spectrum antibiotics
4)Administer 30ml/kg crystalloid for hypotension or lactate greater
than or equal to 4mmol/kg
Septic Shock Bundle
To be Completed Within 6 Hours:
1)Apply vasopressors (for hypotension that does not respond to
initial fluid resuscitation) to maintain a mean arterial pressure
(MAP) greater than or equal to 65mmHg
2)In the event of persistent arterial hypotension despite volume
resuscitation (septic shock) or initial lactate greater than or equal
to 4mmol/L
a.Measure central venous pressure (CVP)*
b.Measure central venous oxygen saturation (ScvO2)*
3)Remeasure lactate if initial lactate was elevated*
*Targets for quantitative resuscitation included in the guidelines are CVP
greater than or equal to 8mmHg, ScvO2 greater than or equal to 70% and
normalization of lactate
> To print a pocket card please access the following link
References:
*International guidelines for management
of severe sepsis and septic shock: 2012.Crit Care Med. 2013; 41:580
*Mayclinic
*Survivingsepsis.org
1. NCHS Data Brief No. 62 June 2011 – Inpatient Care for Septicemia or Sepsis: A Challenge for Patients and Hospitals 2. Wood KA, Angus DC. Pharmacoeconomic implications of new therapies in sepsis. PharmacoEconomics. 2004;22(14):895-906
* Sepsis Alliance  http://www.sepsisalliance.org
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