Sepsis

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Sepsis is a potentially life-threatening complication of an infection. It occurs when the body’s response to an infection causes widespread inflammation, potentially leading to multiple organ failure and death if not treated quickly.

Emergency Signs of Sepsis

Call 999 immediately or go to A&E if you or someone else experiences any of these symptoms:

  • Loss of consciousness
  • Severe breathlessness
  • High or low body temperature (fever)
  • Confusion or disorientation
  • Slurred speech
  • Cold, clammy, pale, or mottled skin
  • Fast heartbeat
  • Rapid breathing
  • Chills and shivering
  • Severe muscle pain
  • Feeling dizzy or faint
  • Nausea and vomiting
  • Diarrhoea

Causes of Sepsis

Normally, the body’s immune system fights off infections through localized inflammation, using white blood cells to attack germs. However, if the immune system is weakened or the infection is severe, it can spread throughout the body. This can cause:

  • Widespread inflammation that damages tissues.
  • Reduced blood flow, leading to dangerously low blood pressure.
  • Oxygen deprivation for organs and tissues.

Common Sources of Sepsis

Sepsis can develop from infections in any part of the body, but common sources include:

  • Lungs (e.g., pneumonia)
  • Urinary tract (e.g., bladder or kidney infections)
  • Abdomen (e.g., appendicitis)
  • Pelvis (e.g., post-childbirth infections)

Other infections linked to sepsis include:

  • Appendicitis
  • Cellulitis (skin infections)
  • Cholangitis (bile duct infection)
  • Cholecystitis (gallbladder infection)
  • Encephalitis (brain infections)
  • Endocarditis (heart infections)
  • Flu (in some cases)
  • Meningitis (brain and nervous system infections)
  • Peritonitis (abdominal lining infection)
  • Osteomyelitis (bone infections)
  • Urinary tract infections (UTIs)
  • Post-surgery infections

Diagnosing Sepsis

Sepsis is often diagnosed using tests that check:

  • Temperature
  • Heart rate
  • Breathing rate
  • Blood tests

Additional tests to identify the infection source and affected body parts include:

  • Urine or stool samples
  • Wound culture (sample from the affected tissue or skin)
  • Respiratory secretion testing (saliva, phlegm, or mucus)
  • Blood pressure tests
  • Imaging studies (X-ray, ultrasound, or CT scans)

Who is at Risk?

Anyone can develop sepsis following an injury or minor infection, but certain groups are more vulnerable, such as:

  • Infants and very young children
  • Elderly individuals
  • Pregnant women
  • People with urinary catheters
  • Those with chronic conditions (e.g., diabetes)
  • Recent surgery patients
  • People with weakened immune systems (e.g., HIV, leukemia, chemotherapy patients)
  • Hospitalized patients (especially long-term stays)
  • Individuals with wounds or injuries from accidents
  • Patients on mechanical ventilation

Recovering from Sepsis

Recovery times vary based on factors such as the severity of sepsis, overall health, hospitalization duration, and whether ICU treatment was required.

Long-Term Effects of Sepsis

Some individuals experience long-term complications known as post-sepsis syndrome, which can include:

  • Fatigue and lethargy
  • Muscle weakness
  • Swollen limbs
  • Joint pain
  • Chest pain
  • Breathlessness

Symptoms of Sepsis: Recognizing the Warning Signs

Sepsis is a life-threatening condition triggered by an infection, and recognizing its symptoms early can save lives. Symptoms can vary widely and may progress quickly, especially in vulnerable groups like young children, the elderly, and those with weakened immune systems.

Sepsis Symptoms in Children Under 5

Temperature Changes

  • High temperature: Over 38°C (babies under 3 months) or over 39°C (babies aged 3 to 6 months).
  • Low temperature: Below 36°C (measured three times within 10 minutes).
  • Persistent high temperature: If a child shows no interest in anything.

Breathing Difficulties

  • Labored breathing that looks like hard work.
  • Grunting with every breath.
  • Speaking difficulty: Older children may struggle to speak more than a few words.
  • Pausing in breathing.

Eating and Drinking Issues

  • No interest in feeding (under 1 month old).
  • Not drinking for more than 8 hours (when awake).
  • Vomiting that is black, green, or bloody.

Body Symptoms

  • Bulging soft spot on a baby’s head.
  • Sunken eyes.
  • Floppiness in babies.
  • Lack of interest or response.
  • Continuous crying or whining (in younger children).
  • Confusion (in older children).
  • Irritability or unresponsiveness.
  • Neck stiffness, especially when trying to look up or down.
  • No urination or dry nappies for 12 hours.

Emergency Symptoms in Children

Go to A&E or call 999 if your child:

  • Is very lethargic or hard to wake.
  • Feels abnormally cold to touch.
  • Is breathing very fast.
  • Has a rash that does not fade when pressed.
  • Has a fit or convulsion.

Trust your instincts and call 111 if your child’s symptoms worsen or seem more severe than expected, even if their temperature falls.

Sepsis Symptoms in Older Children and Adults

Early Symptoms of Sepsis

  • High or low body temperature (fever or hypothermia).
  • Chills and shivering.
  • Fast heartbeat.
  • Rapid breathing.

Symptoms of Severe Sepsis or Septic Shock

In severe cases, sepsis can progress to septic shock, where blood pressure drops dangerously low. Symptoms include:

  • Dizziness or faintness.
  • Confusion or disorientation (change in mental state).
  • Diarrhoea.
  • Nausea and vomiting.
  • Slurred speech.
  • Severe muscle pain.
  • Severe breathlessness.
  • Decreased urine output (e.g., not urinating for a day).
  • Cold, clammy, pale, or mottled skin.
  • Loss of consciousness.

When to Seek Immediate Help

Call 999 or go to A&E if:

  • You have recently had an infection or injury and experience symptoms of sepsis.
  • You suspect severe sepsis or septic shock in yourself or someone in your care.

Never hesitate to ask a healthcare professional: “Is this sepsis?” Early intervention can be life-saving.

Treating Sepsis: Emergency Care and Treatment Options

Sepsis is a serious medical condition that requires prompt and targeted treatment to prevent complications and improve recovery chances. The treatment plan for sepsis depends on the area affected, the cause of the infection, the organs involved, and the extent of damage.

Emergency Treatment for Severe Sepsis and Septic Shock

Immediate hospital admission is often necessary for severe sepsis or if you develop septic shock, which involves a dangerous drop in blood pressure. Treatment may take place in an intensive care unit (ICU) where specialized equipment supports vital body functions such as breathing, allowing medical staff to focus on treating the underlying infection.

Quick treatment is crucial, as sepsis is treatable when identified early, often leading to a full recovery without lasting complications.

Main Treatments for Sepsis

Antibiotics

The primary treatment for sepsis involves intravenous (IV) antibiotics. Early intervention is essential, with antibiotic therapy ideally starting within one hour of diagnosis.

  • Broad-Spectrum Antibiotics: These are administered first to target a wide range of bacteria while the specific infection cause is identified.
  • Targeted Antibiotics: Once the specific bacteria is identified, treatment may be adjusted to more focused antibiotics.
  • Duration: IV antibiotics may be replaced by oral tablets after 2 to 4 days, with total treatment lasting 7 to 10 days or longer, depending on the severity.

Note on Viral Infections: If sepsis is caused by a virus, antibiotics are ineffective, but they are often administered initially due to the urgency of treatment. Antiviral medication may be provided when necessary.

Intravenous Fluids

Patients with sepsis often require IV fluids to prevent dehydration and kidney failure. Severe sepsis or septic shock patients typically receive fluids for 24 to 48 hours. Monitoring urine output via a catheter helps doctors detect early signs of kidney failure.

Oxygen Therapy

Sepsis increases the body’s oxygen demand. If oxygen levels are low, supplemental oxygen may be provided through a mask or nasal tubes.

Treating the Source of Infection

If a specific source of infection, such as an abscess or infected wound, is identified, additional treatment may be required:

  • Drainage of pus or fluids.
  • Surgery in severe cases to remove infected tissue and repair damage.

Increasing Blood Pressure

If sepsis leads to dangerously low blood pressure, vasopressors are administered intravenously to raise blood pressure. Additional IV fluids may also be given to support this treatment.

Additional Treatments for Severe Cases

In ICU settings, other specialized treatments may be necessary:

  • Corticosteroids: To reduce inflammation.
  • Insulin: To control blood sugar levels.
  • Blood Transfusion: To replenish lost blood.
  • Mechanical Ventilation: A machine-assisted breathing method.
  • Dialysis: A procedure to filter the blood and mimic kidney function.

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