By Sana Ahmed
① Understanding the Ways of the Silent Killer
Sepsis is a life threatening, systemic inflammatory response to an infection.
This is when the body’s immune system develops an extreme response to a discovered or suspected infection and oftentimes the reactions can end up causing damage to the body’s own tissues and organs. This can lead to fatal circumstances if not treated promptly such as poor blood flow, low oxygen levels in organs, a drastic drop in blood pressure and ultimately the patient may go into septic shock. Damage to a severe extent can lead to death and therefore it is vital to get early treatment of sepsis before the body is overtaken by its effects.
As of now, the incidence rate of sepsis has been steadily increasing with around 245,000 cases occurring in the UK each year. With around 48,000 reported deaths attributed to sepsis annually, it is a leading cause of death and claims more lives than lung, breast and bowel cancer combined. With well-timed diagnosis and the appropriate treatment, almost 25% of these deaths can be prevented. Sepsis can kill an affected person in as little as 12 hours so treatment is very much a race against time.
② Hidden Clues and Vital Signs: Discovering Sepsis
Sepsis is a silent killer and often works in subtle ways, masking its symptoms with more general ones so it is often confused with other medical conditions such as severe flu,
or chest infection. This makes it difficult to diagnose sepsis as symptoms are easily misinterpreted. Overlooking symptoms or mistaking sepsis for a different condition can lead to fatal conditions for the patient and therefore doctors must keep a close eye on any concerning clinical signs such as the presence of an infection, confusion, very low blood pressure and an increased heart rate and breathing rate. As of date, there is no single diagnostic test for sepsis and so healthcare professionals use a combination of tests to determine its presence. Once it is confirmed that an infection is present and there appear to be clinical features of organ dysfunction, a diagnosis of sepsis may be made.
A plethora of tests can be conducted to reach a diagnosis. This includes taking blood pressure to assess cardiovascular stability; analysing urine or stool samples; testing of a wound culture(a sample from the affected area); respiratory secretion testing to provide insight into the nature of the infection(can be done by taking a sample of saliva, phlegm or mucus) or studying images from an x-ray, ultrasound or CT scans, enabling professionals to ascertain the extent of tissue damage and visualise any internal abnormalities. A useful tool in determining the extent of organ dysfunction and to monitor the progression of sepsis is the Sequential Organ Failure Assessment(SOFA) Score. This allows doctors to predict the patient’s ICU mortality based on lab results and clinical data. Sepsis can be triggered by infection in any region of the body, most commonly in the lungs, urinary tract, abdomen and pelvis. Consequently, these are key areas of observation when on the lookout for the development of sepsis.
③ Beware the Warning Signs: Decoding its Silent Signals
Although it can be difficult to identify at first, there will usually be some tell-tale signs that the body is dealing with sepsis. This could be: loss of consciousness; severe breathlessness; a high/low body temperature; a change in mental state(confusion or disorientation); slurred speech; suddenly having cold, clammy, pale or mottled skin; a fast heartbeat; fast breathing; chills and shivering; severe muscle pain; feeling faint or dizzy; nausea, vomiting or diarrhoea.
It is also useful to know who’s at risk in order to assess the likeliness of sepsis. Often people who are very young or very old, pregnant or have recently had surgery are more vulnerable. Long term health conditions like diabetes or medical conditions which weaken the immune system(like HIV or leukaemia) can also be a risk factor for sepsis. Furthermore those who are already in hospital with a serious illness, are on medical ventilation, have had to stay in hospital for a long time, obtained wounds or injuries as a result of an accident or are receiving medical treatment known to weaken the immune system(like chemotherapy or long term steroids), are more likely to suffer. Despite this, it is important to keep in mind that anyone could develop sepsis after an injury or even minor infection.
④ Fighting Back: The Battle Against Sepsis
Think of sepsis as a ticking time bomb; the quicker you defuse it the less damage caused. That is why there is such a huge emphasis on fast and efficient diagnosis and treatment of sepsis before the body’s exaggerated response to the infection becomes uncontrollable. Early treatment involves administering antibiotics to the patient within one hour of reaching the hospital and depending on the symptoms, further measures may be taken such as treatment in an intensive care unit, using a ventilator to assist with breathing or conducting surgery to remove areas of infection. Subsequently the patient may be required to stay in hospital for several weeks.
Unfortunately, even after treatment, the body is often trialled with a long recovery along with certain long-term effects. Patients can continue to have physical and emotional symptoms for months or years after having had sepsis. Post-sepsis syndrome can include feeling very tired and weak; having difficulty sleeping; experiencing lack of appetite; getting ill more often; having changes in mood; dealing with anxiety or depression; nightmares or flashbacks or even having post-traumatic stress disorder. The aftermath of sepsis can come with a myriad of challenges and it is crucial to allow time for recovery and have a comprehensive support system to ensure a full and holistic recovery.
Conclusion
By launching an offensive attack on the body and its immune system, overwhelming its defences, and triggering a widespread inflammatory response, sepsis is able to swiftly lay siege to the body. With a mortality rate that surpasses that of many prominent cancers combined, it is paramount to conduct timely diagnosis and treatment of sepsis through various diagnostic techniques and observation of the patient’s clinical conditions. Therefore, increasing awareness and understanding of those demographics particularly affected, and being able to promptly recognise the subtle warning signs becomes an integral part of preserving and saving lives.
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