1. LRTIs and Sepsis Poppy

2. Bronchitis/Pneumonia Bronchitis ▫Infection & inflammation of airways Pneumonia ▫Infection & inflammation of alveoli

3. Signs and Symptoms Signs ▫Fever ▫Tachypnoea ▫Crackles ▫ ↓ or bronchial breath sounds Symptoms ▫Dyspnoea ▫Cough ▫Sputum ▫Wheeze

4. Investigations PEFR Full blood count ( ↑ WCC) U&Es CRP Lactate ABGs CXR Nose & throat swabs (PCR tests) Sputum (microscopy, culture & sensitivities)

5. SEPSIS etc. SIRS ▫>1 of :  Temp 38°C  HR >90/min  RR >20/min  WCC 12x10 9 /dl SEPSIS ▫SIRS + known or suspected infection SEVERE SEPSIS ▫Sepsis + organ failure SEPTIC SHOCK ▫sepsis + hypotension (SBP <90mmHg) despite fluid resuscitation + perfusion abnormalities eg. lactic acidosis, ↓ UO, ↓ GCS

6. SEPSIS 6 1.Give high-flow oxygen 2.Take blood cultures 3.Give empirical IV antibiotics 4.Measure FBC & serum lactate 5.Start IV fluid resuscitation 6.Start accurate urine output measurements

7. CURB-65 Confusion Urea ▫>7mmol/L Respiratory rate ▫>30/minute Blood pressure ▫<90mmHg systolic or <60mmHg diastolic age ≥65 years old if score >1 → admit & if score >2 → IV treatment

8. Antibiotics CAP ▫Streptococcus pneumoniae ▫Staphylcoccus aureus ▫Haemophilus influenzae ▫Amoxicillin/Clarithromycin HAP ▫48-72h after being admitted ▫Often caused by multiple organisms Acute bronchitis ▫Often viral – no antibiotics!

9. Any questions?