Sepsis – What Is It And How To Recognise It

Do you know what sepsis is and would you recognise its symptoms? Are you aware that sepsis is a health emergency and that it can happen to anyone, even if they are young, fit and healthy? Up to 50,000 Kiwis contract sepsis every year!

Ask The Question – “Could This Be Sepsis?”

In its early stages sepsis is very difficult to detect. Someone with sepsis may have an infection that is not improving or be sick without realising. It is very important for parents, caregivers and health professionals to be aware of the potential for an infection to progress to sepsis and ask the question, “Could this be sepsis?”. It can take as little as 12 hours from the earliest signs of infection to organ failure and death. Early prevention, early detection and prompt treatment all lead to better outcomes. For every hour of delayed treatment, the chance of dying from sepsis increases by 8%.

How Does Sepsis Happen?

Also known as blood poisoning, septicaemia, or mate whakatãoke, it happens when an infection that is already underway somewhere else in the body gets out of control, triggering reactions right throughout the rest of the body. The body’s immune system responds abnormally to the existing infection, and starts to attack organs and tissues. It causes a drop in blood pressure which means the circulating blood can’t provide enough oxygen and nutrients to the rest of the body. Severe sepsis is called septic shock – this is when a dramatic drop in blood pressure occurs and organs such as the lungs, heart, brain and kidneys are damaged. If multiple organs fail, this can result in death.

How To Recognise Sepsis:

Seek medical help quickly if you notice one or more of the following signs or symptoms:

• difficult to wake, confused, slurred speech
• muscle pain, feels like the flu
• extreme shivering
• clammy, sweaty skin
• fever
• no urine for a day
• very unwell, in extreme pain or discomfort
• breathing very fast, severe breathlessness
• abnormally cold feeling skin (especially children)
• pale, blue, mottled skin
• high heart rate.

What Infections Can It Cause?

Pneumonia is the number one cause. Other common infections that can cause sepsis are infections of the lung, urinary tract, abdomen, joints, skin or bone, as well as infections of the blood or heart.

Who Is More At Risk?

• Very young, very old people
• People with chronic illness – cancer, diabetes, kidney or lung disease
• Weakened immune system – cancer chemotherapy, on long-term steroids
• Pregnant or just given birth
• Current infection/complication after surgery
• Maori / Pacific Island heritage
• People living in poverty.

Can It Be Treated Successfully?

Patients with sepsis will often be treated in the intensive care unit (ICU) so they can be very closely monitored. Once sepsis is recognised, there are six things that have to be done within one hour (called the “Sepsis Six bundle”) to halve the chance of death. Patients will be given antibiotics, fluid and oxygen. Blood cultures will be taken to find out what is causing the infection and blood lactic acid levels will be tested to find out how much oxygen the body is getting. Urine output is measured to make sure enough blood is getting to the kidneys.

Recovery

It can take a long time to recover from sepsis, and for some, it may mean taking significant time off work or school. Because it affects the whole body, recovery involves the whole body. It is a severe illness that can affect people’s independence and have financial consequences.

Recovery involves not just physical recovery, but psychological and cognitive recovery as well. After sepsis its very common to experience “post-sepsis syndrome” which is a collection of symptoms that vary in severity including extreme weakness and fatigue, breathlessness, aches and pains, difficulty sleeping, weight loss, brittle nails and teeth, and hair loss. Dizziness, headaches, vision changes, intolerance to light and noise, and repeated infections are common. The syndrome also includes mood swings, anxiety, poor concentration and depression.

With any infection, never be too afraid to ask “Could this be sepsis?”. You could save a life if you are able to recognise the signs and symptoms at an early stage.