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SIRS, Sepsis, MODS Cram Sheet

1. SIRS (Systemic Inflammatory Response Syndrome)

Definition:

A systemic inflammatory response to a variety of insults, including infection, trauma, burns, or pancreatitis. Not always infectious.

Diagnostic Criteria (Need 2 or more):

Mnemonic: TEMP-HR-RR-WBC

Parameter

SIRS Criteria

Tip to Remember

Temperature

>38°C or <36°C

Hot or cold fever

Heart Rate

>90 bpm

Tachycardia warning

Respiratory Rate

>20/min or PaCO₂ <32 mmHg

Fast or hyperventilating

WBC

>12,000 or <4,000 or >10% bands

White cells high/low or immature cells

Key Points:

  • SIRS can be infectious or non-infectious

  • Early recognition is crucial

  • Can progress to Sepsis → Severe Sepsis → Septic Shock → MODS

2. Sepsis

Definition: Life-threatening organ dysfunction caused by a dysregulated host response to infection.

Key Features:

  • Infection + SIRS

  • Evidence of organ dysfunction (labs, vitals, clinical signs)

Organ Dysfunction Signs:

Mnemonic: LUNG-H

Organ

Sign

Lungs

PaO₂/FiO₂ <300 (hypoxemia)

Urine

<0.5 mL/kg/hr (oliguria)

Neurologic

GCS <15, confusion

Gastrointestinal

ileus, high bilirubin

Heart

hypotension, high lactate

Labs:

  • Lactate >2 mmol/L → poor perfusion

  • WBC high or low

  • Platelets low (thrombocytopenia)

  • Creatinine ↑ → kidney dysfunction

Treatment:

  1. Early recognition → most important

  2. IV fluids → 30 mL/kg crystalloid bolus

  3. Broad-spectrum antibiotics → within 1 hour

  4. Source control → drain abscess, remove lines

  5. Vasopressors if MAP <65 mmHg (e.g., norepinephrine)

3. MODS (Multiple Organ Dysfunction Syndrome)

Definition: Progressive organ dysfunction in acutely ill patients, often after sepsis.

Pathophysiology:

  • Uncontrolled inflammation → tissue damage → organ failure

  • Microvascular thrombosis → ischemia → multi-organ failure

Common Organ Failures:

Mnemonic: HUNK-L

Organ

Dysfunction

Heart

Low BP, arrhythmias

Urinary

Acute kidney injury, low urine

Neuro

Confusion, delirium, coma

Lungs

ARDS, low oxygen

Kidneys

Oliguria/anuria

Liver

Jaundice, high bilirubin

Hematologic

DIC, low platelets, bleeding

Key Points:

  • Early recognition is critical

  • Supportive care: ventilation, dialysis, nutrition, infection control

  • High mortality if untreated

Quick Mnemonics for Remembering Progression

  • SIRS → Sepsis → Severe Sepsis → Septic Shock → MODS

  • Sepsis Signs: TEMP-HR-RR-WBC + organ dysfunction (LUNG-H)

  • MODS Organs: HUNK-L (Heart, Urine, Neuro, Lungs, Kidneys, Liver, Hematologic)

Quick Nursing Cheat Tips

  • Monitor vitals q1-2h: early tachycardia, hypotension, tachypnea

  • Assess urine output: <0.5 mL/kg/hr is red flag

  • Check labs: lactate, WBC, platelets, creatinine, bilirubin

  • Early IV antibiotics within 1 hour of recognition

  • Fluid resuscitation: 30 mL/kg crystalloid bolus for hypotension

  • Watch for organ failure: lungs (O₂), kidneys (UOP), liver (bilirubin), brain (GCS)