SEPSIS PATHOPHYSIOLOGY IN 7 SIMPLE STEPS (2018)


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.