Okay. What is an infection?
Well, that seems really simple.
Most of us know what an infection
is, but I want to break it down
because, as a nurse, you really
want to understand
the impact of an infection, what signs
and symptoms to look for,
and what we do to try to treat it.
I remember one of my first patients
I was horrified to learn,
they were in for a brain abscess, but
do you know how it started?
From a bad tooth.
They were too afraid to go to the dentist,
so they didn't get the tooth treated,
and eventually, they ended up with
a massive infection in their brain,
having them to do a craniotomy to
drain the pus from in their brain.
So infections can get way out of control,
and that is an extreme one.
But if that patient had been
educated and knew that
if we could have taken care of
the infection early enough,
we could have given them
some simple medication
and avoided a phenomenally
long hospital stay.
Okay, so let's break it down on
what actually an infection is.
We talked about what my host
defenses are, right?
The intact skin, the cilia, the gastric
acid, my immune system,
but something happens that
breeches or compromises
or overpowers that infection,
all those host defenses can help
keep me pretty safe.
We can fight off lots of things. In fact,
did you know that your immune system
can actually defeat some cancers?
That just blows my mind when
you think about that.
So, now I'm talking about infection means
my normal host defenses are breached.
Somehow, they're compromised
or they're overpowered,
so that's what leads to an infection.
So, what happens is bacteria, somehow,
breaks my host defenses. I either
take it in in my mouth,
my nose, my ears, the pores of my skin, or,
like you'll see in our example in just
a minute, the skin is broken.
Okay, so then the bacteria start to grow
and to multiply in the body tissues.
That is so creepy, isn't it? Sounds
like something from a movie.
So, first of all, normal defenses are breached,
compromised, or overwhelmed
that bacteria get into my body,
and then they start to multiply
in my body tissues.
Then the defense system just can't handle it,
it becomes overwhelmed.
Now, the reason may be that
People that are on certain chemotherapy
drugs for cancer
are definitely immunocompromised.
People who are taking corticosteroids
that suppresses inflammation, they
can be immunocompromised,
depending on how large the dose is
and how long they've been on it.
Other people just have some
immune system problems.
So, anyone who is immunocompromised
is especially at risk to
develop an infection.
Okay, so we've talked about, somehow,
the normal host defenses are breached,
the bugs get in your body, and then
you become overwhelmed.
So, take a look at this picture that
we have for you there.
Look, you've got someone who's
skinned their knee, which
I know doesn't seem like a traumatic injury,
but remember what a big deal it was
when you were a little kid.
This is showing you what a normal
immune response is.
So, in the first, you see that there's
some type of break in the skin.
Now, that could be anything:
a paper cut, a skinned knee,
you cut your finger
when you're making dinner, anything
where the skin is punctured.
What happens then is, that's the
point of entry for the bacteria.
So the invader, you've got this really
ugly, nasty bacteria,
invades or enters your system through
that break in the skin.
So that's why you want to be careful
whenever you have a patient
who has any type of puncture, whether
we're giving them an injection,
we're doing a finger stick,
they have a surgery or a procedure
that breaks the skin,
they're at an increased risk for infection.
So we've given the "Welcome Home"
sign to the bacteria, right?
There's a break in the skin,
the bacteria enter,
and they invade the body through that cut.
Now the immune cells are
hanging out in our system,
and they've started to gather
once they see that bacteria
because the antibodies have
marked them for destruction.
The immune cells know who to charge after,
and they begin to destroy and digest that
nasty bacterial invader and its antigens.
But remember, how many bacteria
are we dealing with?
Well, that depends on how
strong the bacteria is
because once they enter that cut,
their job is to start to multiply,
and that's what they try to do.
So that's when the battle begins.
The bacteria trying to multiply
as quickly as they can,
and some bacterial infections
just take minutes to hours to multiply.
While they're trying to multiply,
your immune cells are trying to identify
those targets and kill them, digest them.
How we end up with infection is when
our immune system is overpowered
by these nasty bacteria. They're
either outnumbered or
outmanned, so that's how infection happens.
So once you have that in mind,
that will help you be aware and alert when
you're taking care of any of your patients,
to know things that put them
at risk for infection.
Anytime the skin is punctured,
whether we're doing a diagnosis
or a procedure,
or they happen to have a traumatic injury.