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What causes sepsis?

Identifying and treating a dangerous blood infection

Sepsis, sometimes called blood poisoning, affects more than 1 million Americans each year, and estimates indicate as many as half of people diagnosed will die, according to the National Institutes of Health.

The prevalence of sepsis is a hot topic in the medical community as the Centers for Disease Control and Prevention (CDC) has recently increased its efforts to inform the public about sepsis. In fact, a recent research letter published in the Journal of the American Medical Association (JAMA) indicates the infection drives a higher number of 30-day hospital readmissions versus that of heart attack, chronic obstructive pulmonary disease (COPD), heart failure and pneumonia – leading to higher medical costs and longer hospital stays.

Novant Health and Novant Health UVA Health System have established standardized protocols for catching signs of the infection sooner.

“We were given the opportunity to build an order set for sepsis and be the pilot program for education and recognition within the organization,” said Tiffany Fischer, emergency department nurse manager at Novant Health UVA Health System Prince William Medical Center. “We got a team together and partnered with our bedside nurses to gather feedback and really understand what information they needed to make sepsis easier to recognize and diagnose.” 

What it is

“Sepsis can be caused by a variety of infections and occurs when a patient’s immune system overreacts, leading to inflammation that can cause blood clotting, organ damage and death,” said Tracy Forster, senior director of nursing at Novant Health Matthews Medical Center. “Sepsis usually begins as an infection in just one part of the body, such as a skin wound. Most infections stay localized, but some can become septic, causing a swift cascade of symptoms that can kill quickly.”

“Since sepsis is fatal 28 to 50 percent of the time, the timeframe for treatment is a significant focus when caring for patients with this condition,” said Donna Pfost, emergency department nurse manager at Novant Health UVA Health System Haymarket Medical Center. “We put a lot of focus on recognition because patients can deteriorate so quickly.”

Symptoms and risks

Common symptoms of sepsis include fever, chills, rapid breathing and heart rate, rash, confusion and disorientation, according to the CDC. Many of these symptoms are shared by other conditions, so sepsis can be difficult to identify in the early stages. To make a diagnosis, doctors examine abnormalities in body temperature, heart rate, respiratory rate and white blood cell count.

Anyone can get sepsis, but the risk is highest in people with weakened immune systems, infants and children, the elderly and people suffering from severe burns, physical trauma or chronic illnesses such as diabetes, AIDS, cancer, and kidney or liver disease.

The over-prescription of antibiotics can also raise the risk of sepsis. The CDC has identified the overuse of antibiotics as the No. 1 factor contributing to the rise in superbugs that are resistant to these medications.

“People can become septic when an antibiotic doesn’t treat their infection because the bacteria have become resistant to the drug,” Pfost said.

Drug-resistant bacteria cause 2 million illnesses and roughly 23,000 deaths in the U.S. each year, according to the CDC. Antibiotics are often prescribed to treat the common cold, flu and cough illnesses such as acute bronchitis, even though these infections are viral and not bacterial, meaning that antibiotics are not an effective treatment.

Treatment and recovery

Nearly all sepsis cases require intensive care for days – or even weeks – until the infection resolves.

Many people who survive severe sepsis recover completely, but some may experience permanent organ damage.

Prevention, screening and awareness

Anyone with minor cuts, scrapes or infection should monitor them to ensure they don’t develop into sepsis.

“It’s important to catch sepsis early for the best prognosis,” said Forster, adding that most hospitals now have screening systems in place to catch sepsis. “Novant Health has developed tools and procedures to screen patients who are experiencing infection or systemic inflammation for sepsis, including screening for fever, increased heart rate or respiratory rate and abnormal lab work.”

Team members at Haymarket Medical Center, Novant Health UVA Health System Prince William Medical Center and Novant Health Rowan Medical Center worked together on the screening tool to make it easier for nurses to recognize the signs and symptoms of sepsis.

Find out what the CDC is doing to help prevent sepsis at cdc.gov/sepsis


Published: 2/21/2017
 

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