Tara has taught staff nursing courses and has a master's degree in public health.
Systemic Inflammatory Response Syndrome
Jane is a third year nursing student who is trying to learn about the body's immune system. Jane went to her clinical site today and cared for a patient who had an elevated temperature and an elevated heart rate. Jane assumed that he must have had an infection in his body, but was told that he did not. The nurse who was caring for the patient told Jane that he is exhibiting signs of Systemic Inflammatory Response Syndrome (SIRS).
Jane decided to go home and read more about this syndrome referred to as SIRS. Jane discovered that SIRS is the clinical signs of the body's immune system activating. Patients are considered to display SIRS criteria if they have any two or more of the following symptoms:
- Temperature above 100.4F or below 96.8F
- Heart rate above 90 beats per minute
- Respiratory rate above 20 breaths per minute
- Arterial Carbon Dioxide level (PaCO2) of less than 32
- White Blood Cell count of more than 12,000 or less than 4,000
Could Be Infection, Maybe Not
Jane thinks about what she has read and remembers her patient. Her patient had a temperature of 101F and a heart rate of 98. However, the nurse said there was no infection present in the body. Jane is confused. It would seem that a patient who exhibited these symptoms would have an infection present.
Upon further reading, Jane discovers that SIRS is a common inflammatory response that could be caused by infection. However, infection is not the only cause of these symptoms. Some of the most common causes of SIRS are burns, trauma, cardiovascular disease, cardiac arrest, lung disease, and the body's peri-operative response, especially in cardiovascular surgeries. Jane reflects on her patient and realizes that he was admitted for an exacerbation of a chronic lung condition. As she thinks about these symptoms, she realizes the lung condition must be causing him to exhibit SIRS.
Jane finds it interesting that so many conditions could cause the body's immune system to produce a response. She wonders why the experts decided to give this response a name and a set of criteria. Upon further reading, she discovers that since the body naturally produces this response, the set of clinical manifestations needed to be specifically defined. If this response criterion to a non-specific insult to the body could be recognized, then the cause could be further investigated and determined based on each patient's scenario. Once the main cause of the problem is identified, then it can be treated appropriately.
This lesson has defined Systemic Inflammatory Response Syndrome (SIRS) as the group of clinical signs that display the body's immune system activating. We have learned that patients with this syndrome present with two or more immune response systems. There are multiple issues that have the potential to cause SIRS, such as trauma, burns, infection, cardiovascular disease, cardiac arrest, lung disease, and the body's own peri-operative response. We have learned these details in order to better recognize possible SIRS in our patients. In doing this, we can help the medical team further investigate the cause so the patient can get the best care possible.
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