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The Paediatric Consultation
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Whenever a patient presents with symptoms or signs raising the possibility of infection, sepsis should be considered. Sepsis is a time-critical emergency and warrants immediate intervention with completion of the ‘sepsis six’ within an hour, as shown in Box 94.1.
Obstructive uropathy
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
Where a patient presents with acute renal colic, raised inflammatory markers, impaired renal function and signs of sepsis.Start IV fluid resuscitation and perform ‘Sepsis six’ protocol (oxygen, IV fluids, monitoring of urine output, blood cultures, taking lactate and blood and giving IV antibiotics stat).Arrange urgent CT KUB to confirm diagnosis and request early senior inputIf there is evidence of infection and obstruction, urgent early drainage is required either via retrograde ureteric stent placement or nephrostomy (percutaneous drainage of the kidney by radiological placement of a drainage tube; this is often the preferred option if the patient is too unwell for general anaesthesia or if there are suggestions that retrograde stent placement may fail, e.g. a very large, impacted ureteric stone)
Microbiology
Published in Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury, OSCEs for the MRCS Part B, 2017
Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury
The ‘Sepsis Six’ is a series of three diagnostic and three therapeutic steps (all to be delivered within 1 hour of the initial diagnosis of sepsis) designed to reduce the mortality associated with sepsis. It was designed in 2006 as part of the ‘Surviving Sepsis Campaign’ and its use has been associated with a reduction in mortality, decreased length of hospital stay and fewer Intensive Treatment Unit (ITU) admissions.
Risk factors for disease progression in hospitalized patients with COVID-19: a retrospective cohort study
Published in Infectious Diseases, 2020
Wei Hou, Wei Zhang, Ronghua Jin, Lianchun Liang, Bin Xu, Zhongjie Hu
Seven out of 101 patients (6.9%) developed acute respiratory distress syndrome (ARDS). Seven patients were complicated with sepsis; six of them developed into septic shock. Cardiogenic shock and arrhythmia were found in 3 patients and seven patients, respectively. The proportion of myocardial injury, acute renal injury, and liver injury was 23.8%, 11.9%, and 37.6%, respectively. Nine patients developed a secondary bacterial infection. The rate of secondary bacterial infection in the progression group was 47.1%, which was significantly higher than that in the improvement group (1.2%).
Sepsis in urology – where are we now? And where are we going?
Published in Scandinavian Journal of Urology, 2020
William Duggan, Diarmaid Moran, Ben Challacombe
The key principles of sepsis management are after recognising early signs of sepsis, appropriate blood and urine cultures are taken before simultaneous fluid resuscitation and prompt administration of empirical anti-microbial agents. The Surviving sepsis campaign provided us with the ‘Sepsis six’, a clear, stepwise approach to investigating and managing patients with suspected sepsis. The ‘Sepsis six’ has revolutionised the international approach to sepsis management and has highlighted how early recognition and management can greatly improve a patient’s chances of survival [19].
Descriptive contents analysis of ParticiPAte CP: a participation-focused intervention to promote physical activity participation in children with cerebral palsy
Published in Disability and Rehabilitation, 2022
Sarah E. Reedman, Lakshmi Jayan, Roslyn N. Boyd, Jenny Ziviani, Catherine Elliott, Leanne Sakzewski
There are few content analyses available for therapy interventions aiming to change the health behaviour of patients. Guidance for the coding and linking procedure was therefore drawn from a recent published analysis of content of an implementation intervention to increase the uptake of an evidence-based intervention called ‘Sepsis Six’ by clinicians in one hospital in the UK [23].