Dangers of Sepsis

Mickie, a 56 year-old teacher, has a red, inflamed sore on her leg that won’t go away. Today her entire thigh looks red and angry. Twelve year-old Joey was bitten by a cat, and now has streaks running up his arm. Fred is 97; he’s in good health aside from occasional urinary tract infections, but the last few days he seems unusually confused and woozy. Mabel has emphysema, but has managed well until a recent respiratory infection. Today she’s breathing rapidly and has the chills. Bob lives in his camper and has had abscesses on his arms, legs and toes. The sores won’t heal and now he is just too tired to get out of bed. Amy’s stomach is bloated even though she has not been able to eat for a week. She just sits on the couch feeling miserable.

Mickie, Joey, Fred, Mabel, Bob and Amy all have sepsis - an infection that has spread to their bloodstream.

What is Sepsis?

Sepsis is a life threatening condition that kills more Americans each year than breast, lung and prostate cancer combined. It occurs when the body’s response to an infection causes injury to itself - you can think of it as “friendly fire.” Unfortunately, the “friendly fire” ignites a cascade of events that cause widespread inflammation. Without adequate blood pressure to deliver oxygen, the body goes into survival mode - directing blood to the heart and brain at the expense of the skin, liver, kidney and lungs. Organs begin to show signs of stress, and eventually fail. The mortality rate from sepsis doubles with each additional organ system affected. For those who survive severe sepsis and septic shock, permanent organ damage or mental or physical impairment are not uncommon.

Who is at Risk?

Those most at risk of developing sepsis are the young and old, those with a compromised immune system or chronic illness, or anyone undergoing a surgical or invasive procedure or recent treatment with a broad-spectrum antibiotic. Infections of the skin, abscesses, wounds or burns, pneumonia or respiratory tract infection, urinary tract infections, a broken bone or even a viral infection -- all of these can potentially lead to sepsis.

What to Look For?

Many people with sepsis experience a fever or chills early on. The young or old may have an abnormally low body temperature. Other common symptoms are a fast heart rate, general weakness, warm skin that is sometimes accompanied by a rash or swelling, rapid breathing, feeling woozy when getting up, or not passing urine. All are signs that cannot be ignored, and if you have more than one of these symptoms you should be seen immediately for treatment.

The greatest challenge of sepsis is that there is no single test to diagnosis it -- and it is seldom the first condition a medical provider will think of. And as patients, we seldom think of it either -- after all, who isn’t sporting a cut or two at any given time. But we usually do have a sense when something’s just not right. According to Dr. Jim O’Brien of the Sepsis Alliance, that’s when you can help simply by asking your provider: “Could this be sepsis?”

The first hour is critical. The first 24 can be decisive.

Once organ systems are compromised, every hour that a systemic infection is not treated with antibiotics and fluids, a patient’s risk of death rises by 7%. Diagnostic tests needed will include blood cultures and lab work. Treatment will likely include fluids to maintain or restore blood pressure and broad-spectrum IV antibiotics until the source of the infection is identified and treated. Other medications and procedures may be necessary to support heart, lung, and kidney function.

How about here in Sidney?

Only five years ago, Sidney Health Center saw about one case of severe sepsis each month. In 2013, there have been 20 cases. Nationally, the incidence of sepsis has been rising about 10% per year. Early identification of sepsis and prompt implementation of treatment protocols could save hundreds of thousands of lives.

In response to this increase, Sidney Health Center has become more vigilant in early screening for sepsis and protocols to promptly treat the sepsis preventing progression to total organ failure.

Conclusion

40% of patients diagnosed with severe sepsis do not survive. The Sepsis Alliance collects the stories of sepsis survivors, and stories written by family members of those who have died. The collection, called the “Faces of Sepsis” can be read on the Sepsis Alliance website (www.sepsisalliance.org/faces).

At any time there is a chance that a local infection will become systemic and result in sepsis. Don’t delay care - it could cost you much more than a doctor’s bill. Until there is a definitive test available, prompt recognition of symptoms caused by sepsis is the best way to save lives. For more information, visit the websites of the Sepsis Alliance, the Surviving Sepsis Campaign, or talk to your health care provider.

 

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