Early identification and treatment of sepsis
Sepsis is a medical emergency. Early identification and treatment are essential but many health staff are unable to recognise its signs and symptoms
IN THIS ARTICLE…
Anatomy of sepsis
Signs and symptoms that can help professionals identify sepsis
Effective sepsis management strategies
Sepsis is a potentially fatal condition and is becoming increasingly frequent, yet health professionals are often unable to recognise its symptoms. It is the body’s exaggerated response to infection and, if left untreated, will lead to severe sepsis, multi-organ failure and death. Nurses play a vital role in identifying patients with sepsis and starting essential treatment. This article looks at how sepsis can be identified and effectively treated to improve survival.
5 KEY POINTS
- Sepsis is one of the leading causes of death in hospital patients worldwide
- Patients with severe sepsis will not respond to fluid replacement
- Sepsis can be identified during routine observations so nurses play a vital role in spotting symptoms
- All patients with sepsis should have a management plan that includes level of observation, review schedule and an escalation plan
- Clear guidance on identification and evidence-based interventions is available to support effective and safe care
Sepsis is one of the leading causes of death in hospital patients worldwide and severe sepsis causes around 37,000 deaths in the UK every year (Daniels, 2011). This is more than breast and bowel cancer combined, yet awareness of the condition remains limited. Despite various campaigns and the availability of good evidence for treatment, the death rate associated with sepsis remains high, mainly due to poor identification and delayed interventions.
Defined as “a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs” (Czura, 2011), sepsis can present in any patient and in any clinical setting. As such, all nurses need to be aware of its development, how it can be identified and the care patients need to survive. This article discusses the pathophysiological changes caused by sepsis, how these present in patients and how best to manage sepsis to prevent death or long-term disability.
Chege and Cronin (2007) described early evidence of treatment for sepsis as existing as far back as the early Chinese emperors. However, it was not until 1991 that definitions of sepsis were agreed and later published (Box 1) (Bone et al, 1992). These underpin more recent research and guidance from leading campaign groups such as the Surviving Sepsis Campaign (SSC) and Global Sepsis Alliance. SSC - a partnership of international critical care, medical and emergency care societies - aims to raise awareness and provide guidance based on the best available evidence. In the UK, SSC guidance is being changed to improve both the identification of patients at risk of developing severe sepsis and the delivery of early treatment.