1. What is Sepsis
   1. Sepsis
   2. SIRS
      1. Temperature > 38 or < 36
      2. HR > 90
      3. RR > 20/ m
      4. WBC > 12 K or < 4 K
   3. Severe Sepsis
   4. MODS
   5. Septic Shock
2. Prevention
   1. Vaccination
   2. Gamma Globulin
   3. Maternal Group B Strep Rx
   4. Hand washing, Catheter Care
3. Pathophysiology
   1. Imbalance between pro and anti-inflammatory mediators
   2. Endothelial Damage
   3. Immunosuppression
4. Causative Organisms
   1. Gram Positive
      1. Staphylococcus
      2. Streptococcus
      3. Enterococcus
   2. Gram Negative
      1. E.coli
      2. Klebsiella
      3. Proteus
      4. Pseudomonas
   3. Anerobes
   4. Fungi
      1. Candida
5. H & P
   1. General
      1. Fever, chills, rigors, myalgias
      2. Mental status changes, Restlessness, agitation, confusion, delirium, Lethargy, stupor, coma
   2. Respiratory
      1. Cough, Sputum, Dyspnea, chest pain
   3. Urinary
      1. Dysuria, frequency, urgency, flank pain
   4. Abdominal Source
      1. Nausea, vomiting, diarrhea, abdominal pain, constipation
   5. CNS
      1. Stiff neck, headache, photophobia, neurologic signs
6. Differential Diagnosis
   1. Non infectious shock
   2. Bacteremia
   3. Viral disease
   4. Rickettsial illness
   5. Spirochetal disease
   6. Collage Vascular disease
7. Treatment
   1. Fluid
   2. Pressors
   3. Antibiotics
   4. Steroids
   5. Recombinant Human activated protein C
   6. Polyclonal IVIG
   7. Drainage/ Debridement