Blood poisoning can be fatal unless treated in time, says Dr Melanie Wynne-Jones
Sepsis (blood poisoning or septicaemia) develops when our bodies are overwhelmed by infection. It’s five times more fatal than a heart attack or stroke, and kills around 44,000 people of all ages annually in the UK – one death every 14 minutes, and more than a quarter of them are children.
But 10,000 lives could be saved according to the Sepsis Trust.
The charity says severe sepsis strikes more than 150,000 of us, costing the NHS £2.5 billion each year, but that treatment using the Sepsis Six guidelines (see box, below) saves resources as well as lives, by cutting time spent in hospital, and long-term disability.
What is sepsis?
Our immune systems successfully fight off most of the bacteria that attack our bodies. If bacteria do gain access, making us feel feverish, achy and unwell, our bodies can usually overcome them, often without needing antibiotics.
However, sepsis can set in rapidly (even when symptoms appear minor), or develop after several days spent coping with a ‘routine’ skin, urinary or chest infection or surgical operation. It can even develop if you’re already being treated with antibiotics.
You’re more at risk if you’re very young or old, or have diabetes, pregnancy, immune-system disorders or take drugs that suppress the immune system, such as steroids and chemotherapy.
The clue is a sudden, severe and/or unexpected deterioration in someone’s condition as inflammation, triggered by the immune response (SIRS), starts to destroy the body’s own tissues.
This can rapidly lead to septicaemic shock, meningitis, kidney failure and damage to other organs; sadly, one in three people with severe sepsis dies.
What to look for
You may suddenly feel very ill, or even feel that you may be dying. Your temperature can dramatically rise or fall, your heartbeat may feel very rapid, and you may become breathless, and/or have severe muscle aching, headache, neck stiffness, light avoidance, vomiting, diarrhoea and/or shivering.
Feeling faint, looking pale and clammy, and a low urine output are signs that your blood pressure is very low; your arms and legs may look pale/mottled and feel very cold to the touch.
Purplish-red spots or blotches that don’t blanche (disappear) when pressed by a glass can be a sign of septicaemia or meningitis.
Others may notice that you’re slurring your speech, seem confused or are difficult to rouse or are unconscious.
You’re unlikely to have all these symptoms initially, but treatment should be started within the first hour, according to international guidelines, so spotting the symptoms and signs and calling 999 could save your life.
This needs to be quick and to follow new guidelines. You should be assessed immediately; MPs recently recommended that hospitals should have sepsis teams on standby.
The medical team should check blood and other tests as soon as you arrive and start the Sepsis Six – treatments that can double your chance of survival (see box).
You may need weeks of rehabilitation in hospital after this critical illness and/or develop Post Sepsis Syndrome – a wide range of physical and emotional/psychological symptoms.
It may be months before you start to feel more like your normal self.
6 Sepsis essentials
1 High-flow oxygen treatment: to reduce tissue damage from falling blood oxygen levels.
2 Blood cultures: samples which will identify which bacteria are to blame.
3 Broad spectrum antibiotics: to attack the most likely suspects until test results are available.
4 Intravenous fluids (drips): to counteract poor circulation caused by shock.
5 Blood tests (lactate and haemoglobin): to measure severity and monitor progress.
6 Checking hourly urine production: an early warning for kidney failure.