Master Severe Sepsis and Septic Shock Assessment with Picmonic for Physician Assistant

DIC or Disseminated Intravascular Coagulation begins when microthrombi form causing a thrombotic state. Once all platelets and coagulation factors are consumed patients experience hemorrhage. Characteristically patients bleed from any previous puncture wounds and orifices and may have petechiae. PT and PTT values will be increased.

Ischemia causes decreased oxygenation to tissues as a result of microthrombi formation. Severe tachypnea results in an attempt to compensate. Acute Respiratory Distress Syndrome (ARDS) may occur as a result of alveolar damage in the lungs.

Sepsis can present as a high or low WBC count. Sustained sepsis may result in a low WBC or >10% bands (immature neutrophils).

As refractory hypotension leads to septic shock urine output decreases closer to 0, which is termed oliguria.

Septic shock is a form of distributive shock or high output heart failure which is defined as increased cardiac output but unable to meet metabolic demands. In this case the cardiac output is increased however the oxygenated blood is not able to reach the tissues.

With prolonged ischemia, tissues sustain irreversible damage. This irreversible damage leads to organ failure and subsequently death.