While driving a kid to some sort of after school activity recently, I heard a public service announcement on the radio for sepsis awareness. I was somewhat floored by the ad – enough so that a kid asked me what was wrong! I think I was taken aback by an ad promoting awareness of such a complex medical problem. I spent years in residency discussing sepsis, diagnosis, it’s subtleties and implications and I couldn’t wrap my head around how a 30 second ad could make a difference without causing mass hysteria. Unlike stroke and heart attack which have some classic symptoms for which we say, “call 911,” this can be a little more sneaky.
So what is Sepsis?
This disease is an overwhelming response or reaction to an infection. Untreated, it can cause severe illness, disability and death.
The simple story is that our bodies are so eager to fight off infections, that our immune system, at times can be over-zealous. Early in infection your body responds by releasing a host of chemicals that mobilize an army of infection fighting cells and chemicals. What turns the tide to is when this response becomes overwhelming. More is better is definitely not the case here.
What are the Symptoms of Sepsis?
Signs include fever, increased heart rate, feeling faint or passing out (which can be from low blood pressure), feeling confused or increasingly weak, unable to drink fluids and generally feeling horrible. You should seek care immediately if you have these symptoms in the setting of an infection.
Is Sepsis Contagious?
It is not infectious. You still have the infection which can be contagious, but now the sepsis (your bodies overwhelming response to the infection), caused by the infection, is responsible for your severe symptoms. Clear?
What Kind of Infections Can Cause Sepsis?
Any kind of infection can cause sepsis. Most commonly it is from a bacteria that causes pneumonia, urinary tract infections, skin and soft tissue infections, or infections in the abdominal cavity. However, viruses, such as influenza, can also cause this problem.
How is Sepsis diagnosed?
Sepsis is diagnosed by evaluating vital signs and specific blood tests. There is not a single test that proves you have it, but, if we are concerned we will order many tests to look for the damage that can be caused by sepsis. We use blood tests to look for evidence of infection, electrolyte imbalances, clotting problems, problems with your kidney or liver, or impaired ability to get oxygen to all parts of your body.
We also may need to look for infections with imaging tests. This may be done with: X-rays, CT scan, ultrasound or, more rarely MRI.
How is Sepsis Treated?
The most important part of treatment is early and aggressive care. If you think you have signs and symptoms of illness that could indicate sepsis you should be seen immediately. If we determine you have sepsis when you are seen at ER Specialists Urgency Center we will start aggressive treatment and admit you to your hospital of choice.
Most of the treatment is supportive care. If you have a bacterial infection you will receive antibiotics through an IV. A mainstay of early treatment is IV fluids. Medications called vasopressors may be used to maintain your blood pressure if IV fluids alone are insufficient. Difficulty breathing and getting enough oxygen to your body may require that we breath for you for a period of time with a ventilator and, if your kidneys stop working you may require hemodialysis. While sepsis is resolving and your body is healing we use machines and medications to perform the important tasks your body is no longer able to perform.
What are the Risks of Developing Sepsis?
Sepsis is bad enough on its own, however, the longer it is left untreated the more likely you are to develop septic shock or multi organ dysfunction. This is when the liver, lungs, kidneys, GI tract and clotting mechanisms in your body can stop working. This is a life-threatening illness and will require many of the supportive measures above. The more body systems that fail, the higher the risk of dying.
Who is Most at Risk for Sepsis?
Like most infectious diseases, the people most at risk are the young (especially under 3 months), the elderly, people with chronic disease (such as diabetes or heart and lung problems), and the immunocompromised. Immunocompromised folks include those with AIDS; cancer and transplant patients who are taking certain immunosuppressive drugs; people on immunomodulating drugs frequently used in automimmune diseases and those with inherited diseases that affect the immune system.
Can I Prevent Sepsis?
Avoiding contraction illnesses is the best way to prevent sepsis. Frequent hand washing is the most basic thing we can do to prevent some illnesses and staying up to date on the pneumonia, influenza and meningitis vaccines will help. If you do get sick and you are not improving, pay attention to the warning signs of worsening illness and seek care rapidly.
(c) Can Stock Photo / Leaf