🧬 What *is* Sepsis?

💥 Sepsis is not blood poisoning. It’s a dysregulated host response to infection. That means your immune system is doing *too much* — like sending in all the fire engines when a bin’s on fire and accidentally flooding the street.

🧪 Cytokines (chemical messengers) flood the system, causing systemic inflammation. Vessels dilate, capillaries leak, tissues swell, and perfusion drops. It’s a full-body traffic jam with poor delivery of oxygen and nutrients.

🧠 In severe cases, it leads to tissue damage, multi-organ failure, and death if not treated early.

🩺 Why Do We See These Observations in Sepsis?

Let’s break down what’s actually happening inside the body — and why your obs might look like they’re in freefall:

• 🌡️ High Temperature (Fever): Cytokines like IL-1 and TNF-α act on the hypothalamus, raising your core temperature. This helps fight bacteria — but it also increases metabolism and oxygen demand, which puts stress on the system.
• 📉 Low Blood Pressure (Hypotension): Blood vessels dilate and become leaky due to inflammation. Fluid leaks into tissues, reducing circulating volume and causing hypotension. Less pressure = less perfusion = less oxygen to organs.
• ❤️‍🔥 High Heart Rate (Tachycardia): The baroreceptors sense falling BP and signal the sympathetic nervous system. Adrenaline kicks in, and the heart rate climbs in an attempt to maintain cardiac output — but this can only compensate for so long.
• 📈 High Respiratory Rate (Tachypnoea): Cells switch to anaerobic metabolism, producing lactic acid. To correct this, the brain increases respiratory rate to blow off CO₂ and balance blood pH — respiratory compensation for metabolic acidosis.
• 🧠 Altered Mental Status: The brain is extremely oxygen-sensitive. Poor perfusion and the effect of inflammatory mediators lead to confusion, agitation, or reduced GCS — one of the most subtle but serious signs of deterioration.
• 🧪 Raised Lactate: Lactate is a distress signal. It builds up when cells can’t get enough oxygen and resort to anaerobic metabolism. A rising lactate tells you tissues are suffocating — it’s a marker of how bad things are getting, fast.

🔎 Spotting It Early & Taking Action

👶 Elderly, immunocompromised, pregnant, very young — all more at risk. Don’t rely on the classic picture — early sepsis can look like anything.

🚨 Red flags: New confusion, HR >130, RR >25, BP <90 systolic, SpO₂ <92%, reduced urine output, non-blanching rash, recent chemo, rigors.

🧯 What we do: O₂ if hypoxic, fluids if hypotensive, early pre-alert, rapid transport. Early recognition saves lives. Literally.

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