Septic Shock

Septic Shock - A complication of an infection where toxins can initiate a full-body inflammatory response.

Septic shock is least likely to be observed by the radiographer in his department; however he must recognize it as a possible consequence of poor practice of medical or surgical asepsis (free from disease causing contaminants). He may also be called upon to take portable radiographs of a patient in septic shock. In spite of the wide availability and use of antibiotics in recent years, the incidence of septic shock has risen and has a 40% to 50% mortality rate (number of deaths) for its victims.

Gram-negative bacteria (can cause disease in a host organism) are the most frequent causative organisms in septic shock; however, gram-positive bacteria and viruses can also be the cause. When invaded by bacteria, the body begins an immune response by releasing chemicals that increase capillary permeability and vasodilation, leading to the shock syndrome.

Signs and Symptoms - Symptoms of septic shock are divided into two phases:

First Phase:

  1. Skin is hot, dry and flushed
  2. Heart and respiratory rate are increased
  3. Fever, though the elderly patient may not be febrile
  4. Nausea, vomiting and   diarrhea
  5. Normal to excessive urine output

Second Phase:

  1. Cool, pale skin
  2. Normal to subnormal temperature

  3. Drop in BP
  4. Rapid heart and respiratory rate
  5. Oliguria or anuria
  6. Seizures and organ failure if symptoms are not reversed

Radiographer's Response - The radiographer will rarely be the person who initiates action if this condition is present; however, if he cares for a patient in septic shock, he must remember to keep the patient from becoming chilled. This is important because shivering increases the body's oxygen consumption. If the radiographer is first on the scene, he should do the following:

  1. Stop the procedure and notify the physician in charge
  2. Notify the emergency team and have the emergency cart available
  3. Place the patient in a supine position
  4. Keep patient as quiet and calm as possible
  5. Do not leave the patient unattended
  6. If the skin is very warm, cover the patient with a lightweight blanket
  7. Monitor vital signs q 5 min
  8. Prepare for O2, IV and medication administration