Hey there friend, I'm Christina Rafano from nursingschoolofsuccess.com and in this video
we are going to walk through the pathophysiology of sepsis.
Oooff!
Those are 2 tough concepts in nursing school: pathophysiology and sepsis.
But don't worry, I'm going to break this down into 7 simple steps so you can actually understand
it.
And of course, I have a free cheat sheet for you so you can actually remember this stuff.
So be sure to stay until the end of the video and I'll let you know where you can snag that.
Now, if you like nursing school information broken down step by step for you, let me know
in the comments below by commenting with the word, LOVE.
I need to know if you want more videos like this, so if you do, comment below with the
word, LOVE.
Oh, and don't forget to subscribe and hit the bell, because well, I give away a lot
of free stuff.
And you don't want to miss any of it, so make sure to subscribe and hit the bell.
Alright, let's dive into sepsis.
I've broken the process down into 7 steps for you to follow, to make it a little easier
for you.
Now you won't see these steps in a textbook or anything, I just made them up for you to
make learning all of this easier.
So let's go through these 7 steps for sepsis.
So sepsis can occur after the body has been invaded by a pathogen, like bacteria, a virus,
fungi, or something like that.
We'll call these the bad guys.
So these are bad guy pathogens.
So when the bad guy pathogens enter the bloodstream, the body puts out an alert to the immune system
to tell the immune system that it's been invaded by these pathogens.
And this is step 1 of sepsis, where the bad guy pathogens enter the blood the body puts
out an alert to the immune system that it's been invaded.
And now, step 2, the immune system is going to go full force on these guys to try and
get rid of them.
So it's going to send the whole army of white blood cells to go take care of these bad guy
pathogens.
Now, these white blood cells have weapons called inflammatory mediators and cytokines,
namely interleukins, tumor necrosis factor, interferons, and histamine.
And the white blood cells will release these weapons in the blood, which leads to step
3 of sepsis: these weapons the white blood cells released, cause 3 things to happen:
it triggers the blood vessels to dilate (called vasodilation), it triggers the small blood
capillaries to actually kind of separate and leak out blood and fluid (which is called
capillary leak), and it causes the blood to clot.
This vasodilation and capillary leak causes the blood pressure to drop and it causes swelling,
so there is less blood going to the body's organs, because that blood is leaking out
into the surrounding tissues.
And because the blood is clotting, remember that third thing the white blood cell weapons
do is cause the blood to clot, the blood can't get to the organs it needs to get to, which
decreases blood supply to the organs as well.
So here is the biggest problem, and this is step 4 of sepsis: the organs are not getting
the blood that they need.
And this is because of these inflammatory mediators (remember - those weapons the white
blood cells released), these inflammatory mediators cause vasodilation, capillary leak,
and blood clotting.
So as sepsis continues, the organs aren't getting the blood they need, and therefore,
the organs don't have the oxygen they need.
So the organs start to die.
On top of all of this, because the body is not getting the oxygen it needs to function,
metabolic acidosis occurs.
Which is step 5 of sepsis: metabolic acidosis.
Metabolic acidosis means that the pH of the blood is too low, meaning it is acidic.
So the blood is acidic.
This can happen during sepsis because the organs aren't functioning like they should,
and they can't get rid of all the carbon dioxide, lactic acid and waste products that build
up.
Plus, the kidneys usually make bicarbonate, which is a base, to help, but the kidneys
aren't getting blood, so they can't function well and make enough bicarbonate to balance
the pH.
So the blood becomes more and more acidic.
And this can be really bad if it's not fixed.
So, the brain, kidneys, heart, lungs, liver, and all the other organs aren't getting enough
blood to function, because there is so much vasodilation, capillary leak, and blood clotting,
and the blood is now becoming more and more acidic, which can lead to metabolic acidosis.
So you've probably heard of septic shock, and you're probably wondering, how does that
fit into all of this, when does that happen?
Well septic shock is step 6.
And septic shock is sepsis, but it takes it one step further.
In septic shock, sepsis is occurring, but it is not responding to treatment with fluid.
So, if we catch a patient with sepsis, give them enough fluids that would usually help
them get better, and their blood pressure does not improve, then that is considered
septic shock.
For sepsis, we do what is called a fluid resuscitation, which means that they get 30mL of fluid per
kilogram of body weight So if they have sepsis, and their blood pressure
is not getting better with that fluid resuscitation and they need stronger meds to keep their
blood pressure up, than they are considered to be in septic shock.
Now, kind of the last stage of sepsis, and step 7, is called multiple organ dysfunction
syndrome (or MODS for short).
And this happens when 2 or more of the patients organs have failed.
So, sepsis has continued, the organs haven't gotten the blood, oxygen, and nutrients that
they need, so they have stopped working.
So multiple organ dysfunction syndrome happens when 2 or more of the patients organs have
stopped functioning.
Okay, let's recap all of that, because I know it's a lot of information: So when a pathogen
enters the bloodstream, the body's inflammatory response is triggered, which is step one.
And step 2: the white blood cells are going to hit them with inflammatory mediators, which
are basically weapons.
And during step 3, these weapons cause three things to happen: vasodilation, capillary
leak, and blood clotting.
All three of these factors then cause less blood to be delivered to the organs, and the
organs stop functioning, which is step 4.
So step number 4 happens when there is not enough blood flow to the organs.
And step 5, if sepsis continues, metabolic acidosis can happen, meaning that body's pH
is too acidic.
Step 6 is septic shock, which occurs if we try to give enough fluids to reverse the sepsis,
but they do not respond to fluid treatment, that is considered septic shock.
And if it gets even worse, it can go into step 7 of sepsis, which is multiple organ
dysfunction syndrome (or MODS), where 2 or more of the organs have stopped functioning.
Great job, friend!
That was a lot of information I just threw at you.
So be sure to print off the free cheat sheet we have for you so that you can always remember
these steps whether you're at clinical, lecture class, skills lab, or anywhere!
I'll put a link in the description below this video.
Now, I want to hear from you!
If you like step by step guides for nursing school let me know in the comments below by
commenting with the word LOVE.
I need to know if you want more videos like this, so if you do, comment below with the
word, LOVE.
And if you liked this video make sure to hit the like button, share it with your friends,
and of course click subscribe and hit the bell so you never miss a video.
Thanks for watching and generally just being awesome.
Now go become the nurse that God created only you to be.
I'll catch you next time on the nursing school show.