Sepsis – trust your instincts

A very close friend of mine recently had her third child. Baby was a couple of weeks old and we all met for a catch up one day. She didn’t seem herself. She looked pale, was shivering (during the July heatwave!) and felt weak. We knew something wasn’t right but she insisted that she was just tired from the sleepless nights. She’s never been one to make a fuss so we forced her to go to hospital. We heard later that evening that she had been diagnosed with sepsis – a pretty severe case of it. The doctors warned her had she left it any longer, well let’s just say I would be writing a very different version of this story. Thankfully she made a full recovery and we all thank the doctors and nurses at her local hospital for making that happen.

Worryingly, until she was diagnosed, she didn’t know what sepsis in adults looked like. She had received lots of information about recognising signs and symptoms in her children but nothing to help her look after herself. A young female, who had 3 C-sections and post-pregnancy blood transfusions, didn’t have the knowledge to protect herself from the condition she committed to protecting her own children from.

We’ve all heard of sepsis, especially with the recent rise in media coverage, but do we know enough about recognising the symptoms of sepsis in ourselves, friends or loved ones? My friend’s story inspired me to write this article. Read on and become sepsis savvy. It could save a life.

What is sepsis?

Sepsis is a life-threatening reaction to an infection. It happens when your immune system overreacts and starts to damage your body’s own tissues and organs. It isn’t contagious and although very dangerous, can be treated fairly quickly if identified in the early stages.

250,000 people contract sepsis in the UK every year. Of this, 52,000 people die. That’s a mortality rate of 20%.

Signs and symptoms

The Sepsis Trust warn that in adults, it may feel like you have the flu at first. Early symptoms include fever, chills and shivering, a fast heartbeat and quick breathing. Symptoms of more severe sepsis or septic shock include feeling dizzy or faint, confusion or disorientation, nausea and vomiting, diarrhoea and cold, clammy and pale or mottled skin.

NHS advice is to attend A&E immediately, should a child or adult display any of the following symptoms of sepsis:

Babies and young children:

• blue, pale or blotchy skin, lips or tongue
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing (you may notice grunting noises or their stomach sucking under their ribcage), breathlessness or breathing very fast
• a weak, high-pitched cry that’s not like their normal cry
• not responding like they normally do, or not interested in feeding or normal activities
• being sleepier than normal or difficult to wake

Adults or older children:

• acting confused, slurred speech or not making sense
• blue, pale or blotchy skin, lips or tongue
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing, breathlessness or breathing very fast

Who is more likely to contract sepsis?

The following groups of people have been identified as being more likely to contract more severe cases of sepsis. If you know anyone who falls into one of these categories, and you suspect they may be showing signs of sepsis, seek help immediately:

• Very young children or very old adults
• Diabetics
• Those on long-term steroids or on drugs to treat cancer or other conditions
• Individuals who have had an organ transplant and are on anti-rejection drugs
• Anyone who is malnourished (their body hasn’t had enough food)
• Those who have serious liver disease
• People who have a serious illness which affects their immune system, such as leukaemia
• Those who have an infection or a complication after an operation
• Women who are pregnant or have just given birth

Save a life

I encourage you all to take time to familiarise yourselves with the signs and symptoms of sepsis. Your knowledge could be the difference between life and death. The Sepsis Trust have some great FAQs, check them out here.

For our nurses, the RCN has some great resources on identifying sepsis in your patients. Check them out and make time to write a piece of reflection for your upcoming Revalidation.

NHS England also provide information on early warning scores specifically linked to sepsis. Read them here.

Please share this with your friends and colleagues.