ABCDE Approach to Sepsis Training

ABCDE Approach to Sepsis

• The ABCDE approach systematically assesses acutely unwell patients.
• Each stage involves clinical assessment, investigations, and interventions.
• Problems are addressed as identified, and the patient is re-assessed to monitor response to treatment.
• This guide is for training, not patient care.

Sepsis Definition and Characteristics

• Sepsis is a life-threatening organ dysfunction resulting from a dysregulated host response to infection.
• High mortality rate is associated with sepsis.
• Clinical features vary depending on infection source (e.g., pneumonia, UTI, cellulitis).
• Symptoms can be localized (e.g., cough, dysuria) or systemic (e.g., hypotension, confusion).
• Symptoms are often non-specific.
• Sepsis screening tools (e.g., UK Sepsis Trust) help identify patients at risk.
• Patients who look unwell or have a NEWS score >5 should be screened.
• History of recent chemotherapy is a red flag for sepsis due to risk of neutropenia.

Initial Assessment and Airway Management

• Acute scenarios typically begin with a brief handover (patient details, reason for review).
• Patients with sepsis may present with fever, hypotension, and/or tachycardia.
• If unconscious/unresponsive, without signs of life, initiate BLS algorithm.
• If patient can talk, airway patent, assess breathing.
• For airway obstruction, seek immediate expert support (anaesthetist, crash team).
• Perform basic airway manoeuvres while awaiting senior input.
• Head-tilt/chin-lift manoeuvre to open airway (unless suspected trauma/spinal injury).
• Jaw-thrust manoeuvre if trauma/spinal injury suspected.
• Use airway adjuncts (e.g., oropharyngeal, nasopharyngeal airways) as needed.
• Oropharyngeal airways for unconscious patients only. Nasopharyngeal airways for partly/fully conscious patients.
• Re-assess patient after any intervention.

Respiratory Assessment and Management

• Percuss the chest to identify areas of dullness (consolidation, lobar collapse, pleural effusion).
• Auscultate the chest for abnormalities.
• Obtain ABG if SpO2 is low to assess hypoxia.
• Chest X-ray is useful for respiratory infection sources, but shouldn't delay sepsis management.
• Obtain sputum sample for microbiology culture and sensitivity.
• Administer oxygen (non-rebreather mask at 15 L/min) to acutely unwell patients.
• For COPD patients with CO2 retention, switch to venturi mask and titrate oxygen (guided by ABG results).
• Re-assess the patient after any intervention.

Cardiovascular Assessment and Management

• Hypotension (systolic ≤90 mmHg or >40 mmHg drop from baseline) is a sepsis red flag.
• Capillary refill time may be prolonged.

This quiz covers the ABCDE approach for systematically assessing acutely unwell patients with sepsis. It highlights key clinical features, screening tools, and the importance of identifying at-risk patients. Ideal for training purposes, it emphasizes the need for effective interventions and continuous patient monitoring.