Thursday 21 September 2017

Sepsis



Sepsis is back in the news and spotting the signs early especially in the under 5’s is a difficult task

In the elderly, this hidden killer is equally as difficult to recognise http://www.birminghammail.co.uk/news/midlands-news/how-to-spot-sepsis-symptoms-12721014

Sepsis is a hidden killer, and is responsible for more deaths in the UK than bowel, breast and prostate cancer combined. So why is so little known about it?
Surprisingly despite this information a recent survey found that 44% of people in the UK have never heard of sepsis and have little idea that it is a life-threatening emergency. And in an astonishing twist 47% of Care Staff did not know that in a dementia patient the risks are higher, dementia increases the risks of acute organ dysfunction, severe sepsis and mortality in hospitalised older patients.

This article is aimed at trying to increase awareness about Sepsis, what it is, the symptoms and what to do in an emergency. I’m not medically trained by any means but in 2013, I had Sepsis so I do understand a bit about it.

Depending on the infection, sepsis can affect any organ, resulting in a diverse variety of symptoms. If the brain is affected, this may cause confusion; if the lungs are affected, this may result in breathing difficulties. Very young children and the elderly are particularly at risk, along with individuals with pre-existing medical conditions.

The body’s immune response can be simply overwhelmed by the infection, or there’s a dysfunctional response producing too much inflammation. The body may already be immunosuppressed due to a trauma or fighting an initial infection, so the immune response is too weak.

When diagnosed early Sepsis is typically treated through the rapid administration of antibiotics.  Dr Ron Daniels, founder of the UK Sepsis Trust said recently
Often patients are discharged from hospital completely unaware that they’ve had sepsis. They could be admitted with a chest infection and end up in intensive care with multi-organ failure, but they think they’ve just had pneumonia, not realising that’s sepsis.

What are the causes of Sepsis?

Sepsis develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body instead. Severe cases of sepsis can lead to septic shock, which is a medical emergency.

What is Sepsis

Most often the culprit is an infection we all recognise – pneumonia, urinary infections (UTIs), skin infections including cellulitis and infections in the stomach, appendicitis, infected Gall Bladder for example.
Typically, when a person suffers a minor cut, the area surrounds the wound will become red, swollen and warm to touch.

This is evidence the body’s immune system has kicked into action, releasing white blood cells to the site of the injury to kill off the bacteria causing the infection.

The white blood cells and platelets form blood clots in the tissues around the cut.

How can you avoid getting sepsis?

Here's how:
1.    Treat urinary tract infections promptly. A quarter of sepsis cases resulted from urinary tract infections. ...
2.    Clean skin wounds properly. ...
3.    Avoid infections in hospitals.

Sounds simple doesn’t it, but in Care Homes a study found 1 in 20 residents developed a UTI in average month, but many facilities lack preventive measures.  Which leads to the question “How many Elderly Deaths were because of Sepsis due to UTI’s not being treated appropriately?”

What are the three stages if sepsis?

Sepsis affects the body in three distinct stages.

Stage One
An infection invades a specific part of the body – pneumonia affects the lungs, for example – triggering the immune system into action.

The germs and toxins produced by the bacteria or virus leave the original site of infection and enter the bloodstream.

This causes the inflammatory response known as SIRS (systemic inflammatory response syndrome).

Stage Two
Individual organs throughout the body become affected, and begin to deteriorate.

In severe cases, this can lead to organ failure.

Stage Three
More than one organ stops functioning, and the patient experiences cardio-circulatory failure that leads to a sudden drop in blood pressure.
This is known more commonly as septic shock.

What are the signs of sepsis you should never ignore?

If you, a loved one, or in the case of medical professionals their patient, feels “severely sick”, doesn’t appear to be themselves and shows any of the following symptoms, sepsis should be suspected:
·         weakness
·         loss of appetite
·         fever and chills
·         thirst
·         difficult or rapid breathing
·         rapid heart rate
·         low blood pressure
·         low urine output

If a person is suffering these symptoms and they are thought to have suffered an infection – pneumonia, abdominal infection, urinary infection, or a wound – sepsis is a likely cause.

What treatment is available and can you prevent sepsis?

If you suspect you, or a loved one is suffering sepsis it must be treated as a medical emergency.

Think of the reaction you would have to a heart attack, stroke or major car crash – dial 999.

A person’s chances of surviving sepsis are highly dependent on their getting medical intensive care as soon as possible.

The longer it takes to receive medical care the more likely it is a patient will die.
Given it is a condition triggered by an infection, preventing that initial infection can prevent sepsis.

If you are a Parent or Guardian of an Under 5

Parents have been told to visit A&E immediately or call 999 if their child looks mottled, bluish or pale, is very lethargic or difficult to wake, feels abnormally cold to touch, is breathing very fast, has a rash that does not fade when you press it or has a fit or convulsion.

In the Elderly diagnosis of infection is challenging and likely to be missed if not anticipated. The presentation of sepsis in the elderly may be more severe and different from that in younger patients.  Nonspecific signs of sepsis like
·         altered mental status,
·         delirium,
·         weakness,
·         anorexia,
·         malaise,
·         falls,
·         and urinary incontinence
are common in the elderly. 

More common symptoms of sepsis include
·         fever,
·         hypothermia,
·         low blood pressure,
·         and elevated heart rate

The best advice is if unsure or concerned call 999

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