exam. Okay. Slightly different scenario.
year old, Crohn's disease, recovering from
an emergency laparotomy for perf bowel.
These are his observations. SIRS. What are
the components of SIRS? What is SIRS? Systemic
Inflammatory Response Syndrome?
Triad of tachycardia, tachypnea and probably
raised white cell count? And-- Temperature.
Urine output is not part of the
criteria. Temperature, heart rate, white cell
count and respiratory rate.
Some of the ones I’ve seen have had 6 in
them and what have they included.
In the exam?
No, in some books.
This is it. These are crisp
guidelines and this is what they are looking
for. Yeah now I just need to warn you, I’m
sure many of you are revising from books online
resources. Many of these online resources are
not accurate. So you have to be bit careful.
If you are unsure, just refer to the books.
You'll be surprised by who has written these
questions. Many of them haven't been better
at all. Even from established resources, they're
just piling the questions. To sell their website,
they'll say, I got three thousand questions,
four thousand questions. Some of them will be
written by anaesthetist and anything,
written by random people. And they just put
it there because they have to just increase
the number of questions. So be a bit careful
of this revising online. Books are better.
Books are usually proofread, edited, a bit
more safer, because I've worked with both
and I’m quite surprised with the number of
questions that are discussed through the
online resource. Because online, they are
not really particular about the quality, they
just want quantity. They want to say this
site has three thousand questions, four thousand.
Just competing. So they just put through whatever
is coming through without really checking
it carefully. So if you're unsure, stop and
refer. But I would say, books are bit more
safer. Many books have also got mistakes,
Part A books. But you need to check.
Okay so this is the criteria. Common causes
of SIRS. What do you, in surgical patients?
Infection, pancreatitis, burns, trauma, pretty
much anything can lead to sepsis.
So anything can lead to SIRS. Okay, management
of a patient manifesting SIRS? It's more of
supportive. You need to identify the cause,
you need to give supportive treatment.
It’s like how you treat a normal infection.
This particular patient, you need
to go for all of these features, all of these
investigations, but it depends on what you
are investigating. Okay. Antibiotics.
Now the reason I put it right at the end is
because would you give antibiotics for every
No. Yes, that's the thing. So you need
to be absolutely,
to a bit careful in the exam, not to commit to
antibiotics for everyone who is a bit tachycardic.
So unless you have something positive cultured,
you shouldn't start them on antibiotics.