What is Sepsis?
There’s a growing awareness of sepsis as a potentially life-threatening condition. In August 2016, the US Center for Disease Control (CDC) branded the condition a “medical emergency”, after figures showing that 72% of patients diagnosed with sepsis had recently been seen by a doctor or nurse who had failed to make the initial diagnosis. The issue is compounded by the fact that there is no standard test for sepsis and symptoms may vary between patients. What is common in all cases, though, is that sepsis is life-threatening and, if not treated promptly, can be fatal in a high percentage of cases.
Sepsis – A Definition
Scientists and doctors have been arguing for years over a definition for sepsis and the debate still rages on. Sepsis used to be referred to as septicaemia, or blood poisoning, but the definition is wider than that. Sepsis is the body’s overwhelming response to some sort of infection in the body, which if left untreated can lead to organ failure, tissue damage or death. Sepsis can develop after any minor infection but is more common in patients with compromised immune systems, the very young or very old, and people who already have wounds as a result of injury or surgery. As sepsis symptoms vary between patients, doctors look at a range of factors including heart rate, temperature, respiratory rate and blood or urine tests to make their diagnosis.
Symptoms of Sepsis
As awareness of the severity of sepsis grows, there have been increased efforts to educate the public about the symptoms to look out for. Not all symptoms will be present in all patients. In adults and older children, the main symptoms often include a raised heart rate, chills or shivering, rapid breathing, feeling dizzy, muscle pain, slurred speech or confusion. Any of these symptoms, linked with a recent infection or surgery should be treated as a medical emergency and the patient taken to hospital immediately. In babies, other symptoms may include decreased urine production, no interest in feeding, irritability and the baby appearing “floppy”. Many patients who have recovered from sepsis have stated that they knew there was something very seriously wrong and this feeling was not always taken into account by medical staff.
Medical professionals are being encouraged to “Think Sepsis” in any patient with a suspected infection and to act immediately to start treatment. Many hospitals use the Sepsis Six model, aimed at the early identification of sepsis and its prompt treatment. If done within the first hour after sepsis is recognised, the Sepsis Six reduces mortality by 50%. The Sepsis Six is:
- Administering oxygen to keep saturation levels above 94%
- Administering IV antibiotics
- Giving IV fluids
- Taking blood cultures
- Checking lactate levels
- Monitoring urine output
Medical professionals should not wait for cultures to be done in the lab to start antibiotic treatment; a broad spectrum antibiotic should be given immediately and this can be changed later on in treatment. Receiving antibiotics quickly is the main factor affecting patient survival.
Is Sepsis Really on the Increase?
Growing press and news coverage about sepsis and awareness campaigns organised by governments and charities, might lead anyone to believe that sepsis is a growing problem. However, it’s not as simple as that. There is no one test for sepsis, which presents in different ways in different patients. Diagnosis of sepsis depends on the skill or judgement of the medical staff and looking into the past at death records and medical records may show many deaths from post-operative infection but it is impossible to say whether these were sepsis or not. Furthermore, many patients who develop sepsis are already ill, have an underlying medical condition or weak immune system. It is often impossible to separate out the medical conditions and determine which one caused the death.
The Future of Sepsis
Research is ongoing into sepsis, the reasons why some patients develop this serious condition and developing new drugs to treat bacteria which are resistant to conventional antibiotics. Early diagnosis is key to the successful treatment of sepsis and the growing public awareness and protocols for treatment should put sepsis at the forefront of everyone’s minds.
Are you training your medical team to be more alert to patients who may be suffering with sepsis?