Sepsis

Sepsis is a life-threatening condition which occurs when the body’s reaction to an infection goes into ‘overdrive’, causing it to attack its own tissues and organs. The infection can start anywhere in the body, and then when the body responds abnormally to the infection it causes sepsis. Sepsis was previously known as blood poisoning and can lead to people becoming very sick very quickly, and they may even need admission to a Critical Care Unit.

Although sepsis is a common problem, it can be difficult to diagnose. At least 100,000 people each year suffer from serious sepsis as a response to an infection which may have started anywhere within their body. Over 70% of sepsis cases arise outside of hospitals, so recognising possible cases in community settings is vitally important. All health care workers, but especially health care support workers who spend a lot of time with their patients and know them well, need to know about what sepsis is, how they can recognise it and how they can quickly raise the alarm to others so it can be treated immediately. Sepsis affects people of all ages and young people/adults can be affected as much as the elderly. It can arise in hospital settings but most cases occur out of hospital.

Symptoms

The infection that causes sepsis could affect one or many parts of the body. For example, it could come from:

  • a chest infection causing pneumonia
  • a urine infection in the bladder
  • a problem in the abdomen, such as a burst ulcer or a hole in the bowel
  • an infected cut or bite
  • a wound

Many people with these infections get better without needing to go to hospital. However some people may go on to develop sepsis, which can happen very quickly. Therefore we need to recognise it early to treat them before they become seriously ill or worse, die.

Signs

You know your patients, you spend a lot of time caring for them every day. You are the person most likely to notice if they are not quite themselves. Do they not seem right to you? They may look sick or you may have noticed they are getting more unwell. They may have signs of an infection or they may be complaining about the following symptoms:

S LURRED SPEECH
E XTREME SHIVERING OR MUSCLE PAIN
P ASSING NO URINE (IN A DAY)
S EVERE BREATHLESSNESS
I FEEL LIKE I MIGHT DIE”
S KIN MOTTLED OR DISCOLOURED

Depending on where you work and your skill level, if you record their observations, they may or may not have a high temperature. Therefore you need to look at their other observations too:

  • is their respiration rate above 25 breaths per minute?
  • is their systolic blood pressure below 90mmHg?
  • do they seem unusually confused?
  • if you use an Early Warning Score at work is the patient scoring above 3?

If the answer to these questions is yes and they have an infection you need to “Think Sepsis!” and tell a more senior health care worker immediately.

What to do

If you think the person you are caring for has sepsis, tell a registered nurse or the most senior health care professional immediately in any setting. Fast recognition and starting specific treatment is vital within the hour for all patients with suspected sepsis.

What is the RCN doing about sepsis?

We are involved in lots of work with other Colleges and groups to help raise awareness about sepsis so everyone from health care workers to patients and relatives can recognise it and get help early. Want to know more? We have a clinical page on sepsis on the RCN website which will give you more resources and information.