LECTURE 4: INFECTIONS AND SEPSIS

Laxmiben Patel is a 86 year old lady who is wheelchair dependant due to right hemiplegia from a previous stroke, 7 years ago, and is dependent on her family/carers for personal hygiene and feeding on pureed food.

  • She has suffered recurrent UTIs and is on prophylactic OD nitrofurantoin for the last 6 months.

  • She is referred to the hospital by out-of-hours GP for UTI (recurrent UTIs) and pneumonia (crackles on the chest).

  • She is brought by paramedics and accompanied by her family.

  • She is diagnosed as having sepsis/UTI/LRTI in the ED and commenced on Meropenem and fluids.

  • The family are keen for her to go back home.

Q1: How do you diagnose sepsis in older people?

Q2: What are the standards of care versus goals of care in this scenario?

Videos

#LeicGEM educators Prof. Simon Conroy & Dr. Jay Banerjee discuss the management of older/frail patients in the Emergency Department (ED) being admitted with Sepsis to the Acute Frailty Unit (AFU).

Sepsis Screening and Immediate Actions (2016): Dr. Martin Wiese, EM Consultant at Leicester Royal Infirmary, explains how to use the UHL Sepsis Screening & Immediate Action Tool for adults.

Preparation & Administration of Meropenem: how to prepare and administer Meropenem using an aseptic non-touch technique (ANTT®) in the Emergency Department.

Myths and MSUs: this MiniGEM explains how and when to diagnose UTI in older patients, and common pitfalls to avoid!

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