hyperperfusion

[Smash]

Well, as per the guidance, they have Sepsis (or SIRS).

Oh I see, it's a change in terminology. Duly noted.

Anyway, how would you measure and diagnose organ underperfusion? Lactate? StO2? UOP? I would argue, strongly, that anyone who is underperfused enough to have diagnosable end organ dysfunction is going to be hypotensive, certainly by MAP. And if they're not, they soon will be.

I never argued that I would be diagnosing organ hypo-perfusion, but you underline my point to the OP well. Warm skin or a 'normal' systolic BP alone does not a well perfused patient make.

 

[Smash]

Brown, that orange jumpsuit would send even a perfectly healthy person into shock.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

So someone with good cardiac output but low organ perfusion has sepsis? I's confoosed.:unsure: It would seem that there would be more causes than that. Isn't saying that a person with said problem has sepsis like saying the because an animal is covered in black fur that it is a dog?

I'm just a lowly ambulance riding Int. here, but this seems strange.

There are indeed other conditions that would cause such a problem: I used sepsis as one example, thereby ensuring I exhibited my ignorance to the fullest!

Sepsis is a clinical syndrome (SIRS in the setting of a known or strongly suspected pathogen, but I may not be up to date on that neither) not a specific disease.

 

[Smash]

I agree but bloody hell I don't know, what am I, a doctor?

Brown, MBBS <-- Um... yes? I thought MBBS was what you antipodeans got after your name when you hung up your shingle?

 

[usafmedic45]

Lactate? StO2? UOP?

Yes, maybe and yes (assuming you mean urinary output). The big three cheap and easy ways to do it are level of consciousness (cerebral perfusion), extremity perfusion and urinary output (renal perfusion).

 

[LondonMedic]

Yes, maybe and yes (assuming you mean urinary output). The big three cheap and easy ways to do it are level of consciousness (cerebral perfusion), extremity perfusion and urinary output (renal perfusion).

Yep, but they're all hard to measure with any sort of confidence, especially out of hospital.

 

[usafmedic45]

Eh....only if you're concerned with interrater reliability and that's not really a major concern unless you're doing research.

 

[irish_handgrenade]

It is how most of my patients feel when I turn up

prolly the accent... just a thought.:unsure:

 

[MrBrown]

prolly the accent... just a thought.:unsure:

Yeah or our meds with funny names like adrenaline and GTN ... or that blokes in orange jumpsuits swanning out of a red and yellow helicopter are just a bit too much?

Mind you the only person who told me I talk funny was a lady in Dallas!

 

[Smash]

Yeah or our meds with funny names like adrenaline and GTN ... or that blokes in orange jumpsuits swanning out of a red and yellow helicopter are just a bit too much?

Mind you the only person who told me I talk funny was a lady in Dallas!

That wasn't a lady.

 

[MrBrown]

That wasn't a lady.

Well you do have to wonder, a full secondary survey at that time was not appropriate so I'm just not sure.

I mean I tried but you know maybe it got lost in translation I mean I did not think it was too hard to understand; all I said was "Oi mate look here, are you blind as I am or are you just a bit stupid yeah, what the bloody hell does that say, see right there in huge big green letters it says 'DOCTOR' right, do you see that?"