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    Understanding Sepsis

    Ruston Stoltz MD Family Medicine, Deaconess Clinic 07/14/2016

    Sepsis is a serious complication of an infection, and it can happen to anyone.  Young or old, sepsis can be life threatening, as between ¼ and ½ of all individuals who develop sepsis will die from it.
    I want you to know more about this serious illness, especially its signs and symptoms, so that you can recognize them in someone you love and help them get emergency medical care.
    Sepsis is an illness in which the body has a severe response to infection, and is one of the leading complications that physicians watch for in patients—especially those who are hospitalized.

    The symptoms of sepsis are not caused by the bacteria themselves. Instead, chemicals the body releases cause the response. A bacterial infection anywhere in the body may set off the response that leads to sepsis.

    Most common infections that can lead to Sepsis
    Common places where an infection (that can lead to sepsis) might start include:

    • Lungs, such as bacteria pneumonia
    • Bowel (bowel perforation or infection)
    • Kidneys or bladder 
    • Skin, such as in cellulitis
    • Lining of the brain (meningitis)
    • Liver or gallbladder

     Patients who are hospitalized are also at risk for infections that lead to sepsis.  Sepsis can result from infections that the patient was admitted for, or can be a complication of IV lines, surgical wounds, surgical drains, and sites of skin breakdown, known as bedsores.  That’s why hospitals focus so much on infection prevention.

    Sepsis Symptoms
    In sepsis, the body starts to be overwhelmed by the infection and begins to “shut down.”  Blood pressure drops, resulting in shock. Major organs and body systems, including the kidneys, liver, lungs, and central nervous system stop working properly because of poor blood flow.
    A change in mental status and fast breathing may be some of the earliest signs of sepsis.
    In general, symptoms of sepsis can include:

    • Chills
    • Confusion or delirium
    • Fever, or the opposite--low body temperature
    • Light-headedness due to low blood pressure
    • Rapid heartbeat
    • Shaking
    • Skin redness or even pale appearance
    • Warm skin
    • Bruising or bleeding may also occur

    Diagnosis and Treatment of Sepsis
    When sepsis is suspected, a physician will examine the person and ask about the person's medical history.  The infection is often confirmed by a blood test, but a blood test may not reveal infection in people who have been receiving antibiotics. Rarely, some infections that can cause sepsis cannot be diagnosed by a blood test.
    Other tests include:

    • Blood gases
    • Kidney function tests
    • Platelet count and bleeding risk
    • White blood cell count

    Once sepsis has been confirmed, a person with sepsis will often be admitted to the hospital. Antibiotics are usually given through a vein (intravenously). Oxygen is given to the person if needed, and large amounts of fluid are given through the IV. Other medical treatments may include:

    • Medicines that increase blood pressure
    • Dialysis if there is kidney failure
    • A breathing machine (ventilator) if there is lung failure

    Sepsis is often life threatening, especially in people with a weakened immune system or a long-term (chronic) illness, and the elderly.

    Damage caused by a drop in blood flow to vital organs such as the brain, heart, and kidneys may take time to improve. There may be long-term problems with these organs.
    Not all patients survive an episode of sepsis—about ¼ to ½ of all will succumb to sepsis.

    Preventing Sepsis
    Preventing sepsis is more about preventing infection.

    The risk of sepsis can be reduced by getting all recommended vaccines.  You can’t get sepsis from an infection that you’re immune to.

    In the hospital, careful hand washing can help prevent infections that lead to sepsis.  This is not only for doctors, nurses, patient care associates, etc. but for also for visitors-- and the patient themselves!

    Prompt removal of urinary catheters and IV lines when they are no longer needed can also help prevent infections that lead to sepsis.

    Ultimately, the key to preventing sepsis is to prevent infection.  Taking good care of yourself and practicing good cleanliness and hygiene go a long way.  However, even healthy, clean, careful people get infections. So the other key is to know the signs and symptoms that an infection may be getting worse, and contact your physician or get immediate medical attention.

    Sepsis acronym from Centers for Disease Control.  Full sepsis fact sheet may be found here.


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