In the last of a series of blogs around World Sepsis Day, the lead sepsis nurse at East and North Hertfordshire NHS Trust describes how this serious condition causes the body to attack its own tissues and organs which can lead to lasting damage or even death:
Sadly, for many people the first thing they know about sepsis is when they are told they or a loved one has this very serious condition.
Sepsis always starts with an infection, but the infection might not be obvious at first. If you can prevent an infection you will prevent sepsis, which is why it is so important to wash your hands before and after you touch someone you are caring for and wash their hands often too, especially before eating and after using the toilet.
The early signs of something being wrong may seem insignificant, especially in someone with a learning disability or other disability. Signs such as disturbed sleep, loss of appetite or confusion don’t always mean someone has an infection or sepsis but it needs to be considered.
It is really important to know what is usual for the person who is sick so that you can be aware of anything that is different. For some people keeping a health passport up to date is helpful so that if care has to be handed over to someone else they have up-to-date information about what is normal for the person.
If you, or someone you are caring for, doesn’t feel well or they are behaving in a way which isn’t their usual way, think carefully about whether they might have an infection. For example, have they got a cough or does their urine smell bad? Be vigilant: if they have an infection, it could be anywhere, but chest infections are the most common source. Urine, abdominal and skin or wound infections are also common.
If you or someone you care for has any signs of infection, it is important to have them checked out by a doctor; they may need antibiotics. Call 111 and say you are worried about sepsis. It is important to keep a close eye on the person with the infection, make sure they are drinking plenty to help the body to fight infection. If you can, check how much urine they are passing; if it is less than usual despite having enough to drink, tell a health professional as it might be a sign that their kidneys have already been affected.
Sepsis can come on very fast: if a person has an infection and their condition changes from bad to worse, it is important they are assessed for sepsis by a doctor who can test their blood and give them antibiotics in a vein; this usually means going to hospital.
They may be hot one minute and cold and shivery the next. Their breathing may become very fast; they may feel faint. Some people start being sick and having diarrhoea or stop passing urine. Another sign is being confused or difficult to wake up.
A young lady I met recently had heard of sepsis through a story line on Coronation Street which helped her understand when she had the condition.
Jenny is a young lady with a learning disability who went to her mum, Karen not feeling very well. Karen described her as looking blue around her lips and breathing very fast. She said Jenny was drenched in sweat but very cold to touch. Karen told me “I didn’t know what sepsis was at that point, but I just knew I needed to get her to hospital fast”.
Jenny was treated with the ‘sepsis six’ in our emergency department which includes having oxygen through a mask, several blood tests, antibiotics and a ‘drip’ of fluid into her arm.
After a few days in intensive care Jenny recovered. Karen and Jenny wanted as much information about sepsis as I could give them before they were discharged; I shared the sepsis easy read leaflet our trust has developed with Jenny and Karen as well as the UK Sepsis Trust Information leaflets.
Many people who have had sepsis get infections and sepsis again even though they are well when they are discharged from hospital. Giving information to people and their relatives in a way they can understand before they are discharged helps them know what to look for in the future and when they should get medical attention again.
Ten days after Jenny was discharged she felt unwell again. Karen recognised the symptoms of sepsis and brought Jenny straight back to hospital. Although she had sepsis again, Jenny wasn’t so poorly the second time and didn’t need to go to intensive care, possibly because she came in so quickly after recognising the signs. She has since made a full recovery.
I’d urge anybody who is worried that they or someone they know is showing symptoms of sepsis to ring 999 immediately.
- More information about what to look for is available at nhs.uk