Sepsis a Case Study

3146 words 13 pages
The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format.
To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (NMC, 2008) the patient will be referred to as Mr X.
Mr X was an 80-year-old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure.
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They found that early and aggressive fluid resuscitation significantly improved survival if administered within the first six hours.
The Surviving Sepsis Campaign (SSC) utilizes the EGDT to recommend early and aggressive fluid resuscitation in the sepsis resuscitation bundle.
If the sepsis bundles are performed reliably, they can significantly reduce sepsis related deaths (Dellinger et al 2008).
The bundle stipulates that if hypotension occurs, a minimum of 20ml/kg of crystalloid or equivalent should be given.
Under the instruction from the ITU doctor, I gave two further boluses of colloid in addition to a maintenance infusion of a crystalloid. On reflection, I am unsure whether I achieved the recommended minimum amount of 20ml/kg requirement for Mr X.
The selection of fluid products, such as crystalloids or colloids for use in septic patients, such as Mr X, continues to be debated in the current research.
Finfer et al (2004) Performed a study and investigated the use of 0.9% Sodium Chloride and 4% Albumin. The Saline Verses Albumin Fluid Evaluation (SAFE) trial contrasted the administration of 0.9% Sodium Chloride and 4% Albumin as the fluid of choice for fluid resuscitation in septic patients.
The study deduced that colloids offered no benefit over crystalloids relating to mortality, occurrence of single organ or multi organ failure and the length of hospital stay.
Prior to the care of Mr X and writing this case study. I


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