Okay. What is an infection?
Well, that seems really simple.
Most of us know what an infection is, but I want to break it down
because, as a nurse, you really want to understand
the impact of an infection, what signs and symptoms to look for,
and what we do to try to treat it.
I remember one of my first patients I was horrified to learn,
they were in for a brain abscess, but do you know how it started?
From a bad tooth.
They were too afraid to go to the dentist,
so they didn't get the tooth treated,
and eventually, they ended up with a massive infection in their brain,
having them to do a craniotomy to drain the pus from in their brain.
So infections can get way out of control, and that is an extreme one.
But if that patient had been educated and knew that
if we could have taken care of the infection early enough,
we could have given them some simple medication
and avoided a phenomenally long hospital stay.
Okay, so let's break it down on what actually an infection is.
We talked about what my host defenses are, right?
The intact skin, the cilia, the gastric acid, my immune system,
but something happens that breeches or compromises
or overpowers that infection, because normally,
all those host defenses can help keep me pretty safe.
We can fight off lots of things. In fact,
did you know that your immune system can actually defeat some cancers?
That just blows my mind when you think about that.
So, now I'm talking about infection means
my normal host defenses are breached.
Somehow, they're compromised or they're overpowered,
so that's what leads to an infection.
So, what happens is bacteria, somehow,
breaks my host defenses. I either take it in in my mouth,
my nose, my ears, the pores of my skin, or,
like you'll see in our example in just a minute, the skin is broken.
Okay, so then the bacteria start to grow and to multiply in the body tissues.
That is so creepy, isn't it? Sounds like something from a movie.
So, first of all, normal defenses are breached, compromised, or overwhelmed
that bacteria get into my body,
and then they start to multiply in my body tissues.
Then the defense system just can't handle it,
it becomes overwhelmed.
Now, the reason may be that I'm immunocompromised.
People that are on certain chemotherapy drugs for cancer
are definitely immunocompromised.
People who are taking corticosteroids
that suppresses inflammation, they can be immunocompromised,
depending on how large the dose is and how long they've been on it.
Other people just have some immune system problems.
So, anyone who is immunocompromised
is especially at risk to develop an infection.
Okay, so we've talked about, somehow, the normal host defenses are breached,
the bugs get in your body, and then you become overwhelmed.
So, take a look at this picture that we have for you there.
Look, you've got someone who's skinned their knee, which
I know doesn't seem like a traumatic injury, but remember what a big deal it was
when you were a little kid.
This is showing you what a normal immune response is.
So, in the first, you see that there's some type of break in the skin.
Now, that could be anything:
a paper cut, a skinned knee, you cut your finger
when you're making dinner, anything where the skin is punctured.
What happens then is, that's the point of entry for the bacteria.
So the invader, you've got this really ugly, nasty bacteria,
invades or enters your system through that break in the skin.
So that's why you want to be careful whenever you have a patient
who has any type of puncture, whether we're giving them an injection,
we're doing a finger stick,
they have a surgery or a procedure that breaks the skin,
they're at an increased risk for infection.
So we've given the "Welcome Home" sign to the bacteria, right?
There's a break in the skin, the bacteria enter,
and they invade the body through that cut.
Now the immune cells are hanging out in our system,
and they've started to gather once they see that bacteria
because the antibodies have marked them for destruction.
The immune cells know who to charge after,
and they begin to destroy and digest that nasty bacterial invader and its antigens.
But remember, how many bacteria are we dealing with?
Well, that depends on how strong the bacteria is
because once they enter that cut,
their job is to start to multiply, and that's what they try to do.
So that's when the battle begins.
The bacteria trying to multiply as quickly as they can,
and some bacterial infections
just take minutes to hours to multiply.
While they're trying to multiply,
your immune cells are trying to identify those targets and kill them, digest them.
How we end up with infection is when our immune system is overpowered
by these nasty bacteria. They're either outnumbered or
outmanned, so that's how infection happens.
So once you have that in mind,
that will help you be aware and alert when you're taking care of any of your patients,
to know things that put them at risk for infection.
Anytime the skin is punctured,
whether we're doing a diagnosis or a procedure,
or they happen to have a traumatic injury.