Understanding Sepsis: A Serious Condition

What is Sepsis?

Sepsis is a serious condition triggered by any infection, including chest infections and UTIs. The body’s immune system will usually attack and kill foreign bodies and infections which invade the body. Sometimes however the immune system stops fighting the infection and turns on the body. This can cause organ dysfunction, which can lead to septic shock, multi organ failure and death. Sepsis is a medical emergency.

Who can get Sepsis?

One of the most frightening things about sepsis is that it is indiscriminate. It is more likely to affect the very young and the very old, or those with underlying health conditions, but it is sometimes also triggered in those that are otherwise fit and healthy. It is not known why some people develop sepsis in response to infection whereas others don’t.

5 people die from sepsis every hour in the UK.*

2000 children in the UK develop sepsis each year.*

40% of people who develop sepsis are estimated to suffer physical, cognitive and/or psychological sequelae.*

*from the UK Sepsis Trust website: https://sepsistrust.org/about/about-sepsis/

How is Sepsis treated?

The main treatment for sepsis is antibiotics, given intravenously. This should be commenced within 1 hour of diagnosis. Patients may also require intravenous fluids.

If blood pressure is low, vasopressor medication will be administered, which tightens blood vessels and increases blood pressure.

Depending on the functioning of the other organs, further treatment may be required, such as dialysis, mechanical ventilation and surgery to remove damages tissue.  

Quick diagnosis and treatment are key to survival and improved long term outcomes. However, even with treatment, around 30-40% of people with septic shock will die.

The ‘Sepsis Six’

The UK Sepsis Trust has developed the ‘Sepsis Six’ to assist front line clinicians with treating potential sepsis cases early.

This is a set of six tasks that can be performed by non-specialist practitioners at the frontline. These tasks include oxygen, blood cultures, antibiotics, fluids, lactate measurement and urine output monitoring.

The sepsis six bundle as a whole has been shown to reduce the relative risk of death by 46.6% when delivered to patients with severe sepsis within 1 hour*.

*NHS England: https://england.nhs.uk

What do I need to know about Sepsis?

Time is critical with sepsis, but it can be hard to spot. Symptoms are not specific and vary from person to person and are different in children and adults. A good mnemonic for the signs and symptoms of sepsis is TIME (Sepsis Alliance):

T: Temperature – higher or lower than normal

I: Infection – worsening signs or symptoms of the underlying infection

M: Mental Decline – confused, sleepy, difficult to rouse

E: Extremely Ill – severe pain, mottled/blue/pale skin, shortness of breath, unable to stand.

Medics will look for:

• Inflammation: high white blood cell count, CRP or elevated procalcitonin
• Hemodynamic instability: low blood pressure, low venous oxygen saturation or high cardiac index.
• Organ dysfunction: low oxygen level, low urine output, high creatinine in the blood, blood clotting abnormalities, absent bowel sounds, low platelets in the blood or high bilirubin levels.
• Tissue perfusion: high lactate in the blood, decreased capillary filling or mottling.