The word SEPSIS is of Greek origin, and means to “make rotten”. Sepsis has been around for centuries, dating back to 1879 when Louis Pasteur first showed that bacteria were present in blood from patients with septicaemia. The rise in antibiotic use, and therefore resistance, is leading to a growing number of deaths from sepsis. In truth, more people are now dying from sepsis than cancer (Jan 2020, around 48,000 deaths annually in the UK). It is thought to be twice as common as previously thought in the world. Indeed 1 in 5 deaths around the world is caused by sepsis, alarmingly estimated at 11 million a year.
So what is sepsis, the silent killer?The usual response to a body developing an infection, whether bacterial, viral or fungal, is for the immune system to trigger a response and therefore fight the infection. However ,with sepsis the immune system goes into overdrive and instead of just fighting an infection, it starts attacking other parts of the body too. Ultimately it causes organ failure. Even survivors can be left with long term damage and disability. The leading triggers of sepsis are the bacteria and viruses that cause diarrhoeal infections or lung disease.
So what does sepsis look like?
The simple answer to this is, that on occasions, it can look like a healthy individual until that person displays signs and symptoms, which means the sepsis can be in an advanced state of destruction.
Having been a Senior Nurse for 36 years, I missed the clues of sepsis within my own family member’s illness. One Winter’s morning when the influenza season was prevalent, I mistook my family member “feeling rough” ,whilst shivering and shaking under the duvet, for flu. This continued for 2 days until there was an inability to pass urine, despite drinking. This escalated rapidly to a trip to hospital, when 7 days later a discharge letter was brought home with the diagnosis of sepsis.How could I have missed this? I have worked amongst septic patients for the whole of my career. It didn’t occur to me that a healthy individual with no co-morbidities could be struck down, when so apparently well. How wrong could I be?
Sepsis can be clearly divided into 3 stages, although it cannot be denied that they are all intrinsically intertwined. The 3 stages are SEPSIS, SEVERE SEPSIS and SEPTIC SHOCK, the difference being the symptoms and the recovery rate. The earlier sepsis is treated, the better the chance of survival will be.
SEPSIS symptoms include:
- A fever above 38 degrees celsius or below 36
- Heart rate above 90
- Breathing rate above 20
- You must have 2 of these symptoms before a doctor can diagnose sepsis
SEVERE SEPSIS symptoms include:
- Patches of discoloured skin
- Decreased urination
- Low platelet count
- Problems breathing
- Abnormal heart rate/rhythm
- Chills due to fall in body temperature
- Extreme weakness
- Will have all of the above symptoms, plus a low blood pressure (under 90 diastolic pressure)
- Septic shock has a mortality rate of 50%
Signs of sepsis in a child are:
- Sepsis can be especially hard to spot in children and young babies.
- Feeling cold to touch
- Mottled, bluish or pale skin
- Rash that does not fade when pressed
- Very rapid breathing
- Lethargy and difficulty waking
- Vomiting and/or not eating/feeding
- 12 hours without passing urine
Anyone can be adversely affected and attacked by sepsis. The groups that are particularly susceptible are premature babies, diabetics and people with weakened immune systems, such as transplant patients or people having chemotherapy.
So how can we help reduce the numbers of people suffering from sepsis or dying? Early detection has got to be the number one priority. We can all help to prevent infections in the first place by adhering to vaccination programmes, taking antibiotics appropriately, cleaning and caring for wounds and most importantly regular and correct hand washing. Education around all these initiatives is the key.
We must not ignore the signs of sepsis. If caught early, hospitalisation can treat the invasion of this potential silent killer with antibiotics, fluids, oxygen and organ support.
This silent killer is certainly a wolf in sheep’s clothing, and is still being massively underestimated.
Written by Sarah Humphries (ECG, Freelance Trainer & RGN), Wednesday 13th April 2020
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