Sepsis
Learning Objectives:
1. To be able to define sepsis and sepsis 6.
2. To understand the role of health care assistants in the treatment and recovery of patients with sepsis.
3. To explore the issues and challenges for those patients who have been diagnosed with sepsis.
4. To understand the physiological effects of sepsis.
5. To be able to recognise a septic patient.
6. To understand and describe the treatment of a septic patient.
What is Sepsis?
Sepsis was previously known as septicaemia or blood infection.
Sepsis is caused by the abnormal way the body reacts to germs, such as bacteria, entering into your body and developing into an infection.
This results in your body attacking and damaging its own organs and tissues which can lead to septic shock, multiple organ failure and death especially if it’s not recognized early and promptly treated and escalated.
Sepsis (also known as blood poisoning) is the immune system’s overreaction to an infection or injury. Normally our immune system fights infection – but sometimes, for reasons we don’t yet understand, it attacks our body’s own organs and tissues. If not treated immediately, sepsis can result in organ failure and death. Yet with early diagnosis, it can be treated with antibiotics.
How do I get Sepsis?
Sepsis can start from any source of infection in a sufferer’s body including the lungs (pneumonia), bladder and kidney (urinary tract infections), skin injuries such as cuts and bites (cellulitis), abdomen (such as appendicitis), and other areas (such as meningitis).
Sepsis can be caused by a huge variety of different bugs, many of which are common bacteria which we come into contact with every day without making us ill. Viruses and fungi can also cause sepsis.
Who is at risk of developing sepsis?
Anyone can develop sepsis but some groups of people are more likely to develop sepsis, such as if you:
- are very young or very old
- are very frail and/or malnourished
- have a compromised immune system due to taking drugs to treat cancer (chemotherapy), long term steroids or immunosuppressant drugs;
- have diabetes
- have serious illness which affect your immune system such as AIDS, liver disease or leukaemia
- have had an organ transplant and are on anti-rejection drugs
- have had a recent surgery, or other invasive procedures
- have an infection or complication after surgery
- have a wound for example, surgical incision, cuts, burns, blisters or skin infections
- are pregnant, have given birth or had a termination or miscarriage in the past 6 weeks
How do I know I have sepsis?
There is no one sign for sepsis. You may feel like you are developing a flu-like illness, gastroenteritis or a chest infection at first. This makes it difficult to diagnosis sepsis and can result in delays in treatment until the condition worsens and becomes more serious.
SYMPTOMS
Sepsis can initially look like flu, gastroenteritis or a chest infection. There is no one sign, and symptoms present differently between adults and children.
If you recognise these symptoms either in yourself or someone else you should seek urgent medical treatment. Although sepsis is dangerous, a quick response can make a huge difference. Sepsis CAN be beaten – if we all become more aware of the condition and learn to recognise the symptoms, we could save thousands of lives.
EVERY MINUTE COUNTS!
Once in a hospital, a trained physician will usually take the following steps, known as the Sepsis Six:
- Give oxygen to keep your blood oxygen levels normal
- Take blood cultures
- Give IV antibiotics
- Start IV fluid resuscitation
- Check lactate
- Monitor hourly urine output accurately
Treating sepsis is time-critical. Administering the Sepsis 6 bundle, including antibiotics, within the first hour that sepsis has been identified has been shown to double the chance of survival for patients with severe sepsis or septic shock. ‘Bundles’ are groups of clinical interventions or treatments that have been proven to be effective in treating conditions such as sepsis when given together.
How can I prevent Sepsis?
Sepsis is always caused by infection, most commonly by bacteria. That means that preventing infection is one of the best ways to prevent sepsis.
- Get vaccinated against flu, pneumonia, and any other infections that could lead to sepsis if you are in an ‘at risk’ group. Talk to your doctor for more information.
- Prevent infections that can lead to sepsis by:
- Cleaning scrapes and wounds
- Practice good general hygiene and hand washing
3. Following the recommended immunisation schedules can reduce the risk of sepsis in children. Talk to your doctor for more information.
4. Stopping the indiscriminate use of antibiotics can help to prevent bacterial resistance to antibiotics. Ensure that you following your doctor’s instructions for taking antibiotics and complete the full course of treatment. Within hospital, your antibiotic regime will be reviewed routinely to ensure you are on the best and most appropriate antibiotic.
As part of this initiative, we have set out yearly goals to demonstrate progressive improvements over the three years. These goals focus on measuring improvements in delivery of three main interventions and one diagnostic test within one three hours of a patient becoming septic. These are based on elements of the Sepsis 6 Bundle. These include:
- Measuring lactate levels to assess severity of sepsis
- Obtaining blood cultures to identify organisms causing sepsis
- Administration of broad spectrum antibiotics to beat the infection
- Intravenous fluids to prevent dehydration and kidney failure
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