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close this bookClinical Management of Abortion Complications: A practical Guide (WHO - OMS, 1994, 86 p.)
close this folderCHAPTER 6 - MANAGEMENT OF SEPSIS
View the document6.1 INTRODUCTION
View the document6.2 PRESENTATION
View the document6.3 ASSESSMENT OF SEVERITY OF INFECTION AND SEPSIS
View the document6.4 INITIAL TREATMENT
View the document6.5 DEFINITIVE MANAGEMENT
View the document6.6 CONTINUING TREATMENT

6.3 ASSESSMENT OF SEVERITY OF INFECTION AND SEPSIS

When a patient has signs and symptoms of infection, quickly assess the severity of the infection and the risk for septic shock. The following may be seen with pelvic infection:

· foreign material in the vagina

· pus coming from cervix or mixed with blood in the vagina

· signs of local pelvic infection: uterine tenderness, tenderness when the cervix is moved, lower abdominal tenderness, or adnexal tenderness (near ovaries and tubes)

· foul odour to any blood or secretions

· uterine subinvolution.

Assess the woman's risk for developing septic shock using the following guidelines:

Table 7
Risk for Septic Shock

LOW RISK

HIGH RISK

first trimester abortion

second trimester abortion

mild to moderate fever (36.5-38.5°C or 99.5-101.5°F)

high fever (38.5°C or 101.5°F and greater) or subnormal temperature

no evidence of intra-abdominal injury

ANY evidence of intra-abdominal injury:

distended abdomen, decreased bowel sounds, rigid abdomen, rebound tenderness, nausea and vomiting

stable vital signs

ANY evidence of shock:

low blood pressure (systolic less than 90 mmHg), anxiety, confusion, unconsciousness pallor (inner eyelids, around the mouth, palms), rapid, weak pulse (rate 110 per minute or more), rapid breathing (respirations 30 per minute or greater)