Sepsis: The danger is too great to ignore

Even though sepsis is responsible for so many lives, many nurses have difficulty recognizing the early warning signs. And some healthcare providers still aren’t really sure what sepsis even is. Unfortunately, that lack of knowledge is a key influencer of whether or not your patient has a successful recovery from sepsis. But you can learn the early symptoms of sepsis so you can advocate for your patient more effectively, helping them get prompt treatment. Doing so can literally make the difference between life and death.

Understanding sepsis

Sepsis occurs as a life-threatening response to infection somewhere in the body. The physiological reaction is catastrophic. In many cases, overwhelming, system-wide inflammation leads to organ failure, tissue damage, and death.

It’s possible for anyone to get sepsis, but it’s more common in certain patient populations. These include:

• Adults aged 65 or older
• Patients with chronic co-morbid conditions, such as diabetes or cancer
• Patients with compromised immune systems
• Children less than one year old

The danger is real

There isn’t one single reason why sepsis is so dangerous — the danger it poses is multifactorial. First, the signs and symptoms, especially in the early stages, don’t necessarily point to sepsis. In the past, nurses used the systematic inflammatory response syndrome (SIRS) criteria to flag patients with possible septic infections. But many of the early symptoms of sepsis mimic those caused by other diseases or conditions, making the SIRS criteria an unreliable indicator of sepsis.

Recognizing early sepsis symptoms is crucial for initiation of effective therapy, but, for most patients, these initial signs are usually fairly generalized. In most cases, symptoms include fever, chills, tachycardia, confusion, acute shortness of breath, tachypnea, and pain.

For older adults, early symptoms may be completely different. People age 65+ make up an estimated 65% of people with severe sepsis, but they often present totally differently from younger patients. An older adult may show confusion, unsteady gait, or lack of appetite as the only sign that organ failure is imminent.

On top of vague symptoms, there isn’t any specific diagnostic test for sepsis. Most diagnoses are based on clinical evaluation — and when the symptoms are as generalized as those for sepsis, pinning down an accurate diagnosis can be difficult.

Taking action for your patient

Recognizing sepsis quickly is key to your patient’s successful recovery. Research shows that when sepsis protocols are initiated within six hours of symptom recognition, mortality at 28 days is reduced by almost 20%. As a nurse, you’re around your patients more than any other healthcare provider. You know your patient and can identify subtle changes in their health. Your critical thinking skills and clinical decision-making ability are crucially important for early sepsis recognition.

On top of familiarization with the early symptoms of sepsis, acting as your patient’s advocate is an important step toward getting them well again. If you recognize a change, suggest confirmatory laboratory tests, like those that confirm the presence of endotoxins or procalcitonin (PCT) or urinalysis, CBCs, blood cultures, and even PT and PTT tests. These tests are essential for identifying infection or other issues that may result from sepsis. Other blood tests, like SeptiCyte, helps determine whether certain sepsis-related genes are activated.

While we make every effort to function as members of the same team, it’s important to continue to firmly advocate for your patient. Even if you get pushback from other healthcare providers, remember your patient is depending on you to help them recover. Pay attention to any and all changes to your patient, especially if they occur acutely. It’s better to err on the side of caution and have your patient tested for sepsis than to ignore what could be a fatal error.

Further resources

In recognition of September as Sepsis Awareness Month, our colleagues at NursingCenter have assembled a FREE Sepsis resource center with an assortment of infographics, blogs and videos.  Check it out HERE:

The Lippincott® Solutions evidence-based institutional software also contains robust decision-support and CE lesson content on Sepsis, which serves clinicians at the bedside, in the classroom, and during research.

Click HERE to watch an animated video that shows the ‘flow’ of evidence-based information from a Sepsis diagnosis thru our industry leading software.