Sunday, September 22, 2013

Sepsis: What to Know

In the last 15 months, Robert has had pneumonia and sepsis three times.  He was hospitalized in May 2012, April 2013 and just recently, September 2013.  In Robert’s case, these seem to not only go hand in hand but come on quickly with little to zero warning.

During Robert’s bout with pneumonia and sepsis this past April, he actually went into Septic Shock.  His blood pressure dropped so low the medical personnel in the Emergency Room had to start a central line (an IV in the neck) and give Robert Norepinephrine which treats low blood pressure but needs a big vein to go into.

Sepsis scares the heck out of me since it is so serious and seems to come on so quickly.  Fortunately, we live in an area where the teaching hospital Robert goes to for his medical care has made “reducing deaths from severe sepsis and septic shock an institutional priority.” 

In April, we were asked if Robert would participate in a research study aimed at protocols of care for early septic shock. Robert has volunteered to be in numerous research studies over the years for various epilepsy drug and medical devices so I knew he would want to participate in this study. He was not able to consent but since I have Durable Power of Attorney for him, I consented on his behalf.

Once Robert was alert enough, I told him he was in a study to help other people with septic shock.  He was happy to help.

Because Robert seems to be susceptible to pneumonia and sepsis, I have researched both and been given information by the hospital.

I also learned that September 13 was World Sepsis Day and September is Sepsis Awareness Month (who knew?).

As caregivers, the more we know about sepsis, the better prepared we can be in order to advocate for our loved one with a diagnosis of sepsis. (The following information was gathered from several sources.)

What is sepsis?

1.     A reaction to an infection throughout the bloodstream.
2.     Sepsis does not occur by itself; it is a reaction to an infection (such as pneumonia, urinary tract infection or even Appendicitis);
3.     Bacterial infection is the most common cause but sepsis can be caused by a viral or fungal infection as well;

A few facts about sepsis:

1.     Sepsis is the leading cause of death in U.S. hospitals;
2.     750,000 Americans per year will get sepsis;
3.     Between 28 and 50 percent of people with severe sepsis will die (more than U.S. deaths from prostate cancer, breast cancer and AIDS combined);

What are the symptoms of sepsis? (Be aware that while many symptoms can be the same in both children and adults, there can be differences)

Symptoms in Children:

1.     Fever or low body temperature;
2.     Chills;
3.     Fast heart rate;
4.     Breathing changes;
5.     Skin rash;
6.     Less urine output;
7.     Confusion, lethargy;
8.     Nausea, vomiting;
9.     Shaking;
10. Warm skin;

Symptoms in Adults:

1.     Fever or low body temperature;   
2.     Chills;
3.     Fast heart rate;
4.     Rapid breathing;
5.     Skin rash;
6.     Less urine output;
7.     Confusion or light-headedness;
8.     Cool, clammy skin or red flushed skin;

I have found with Robert he develops a skin rash, is confused and usually too weak to stand on his own, has a fever, high pulse rate and low blood pressure. This last time in the hospital he also developed severe shakes which was quite unnerving to see.

Unfortunately, many of these symptoms are symptoms of less severe conditions so it can be difficult to tell if this actually indicates sepsis. It is best to contact the doctor when these symptoms occur or go straight to the emergency room to be on the safe side. 

Treatment of sepsis:

1.     It’s important to start treatment for the infection as soon as possible before the sepsis becomes so bad that it causes organ failure.
2.     Often, the treatment will be in the Intensive Care Unit with a broad spectrum of antibiotics to treat the underlying infection;
3.     IV fluids as well as oxygen is also often used in treatment of sepsis;

Because Robert has had pneumonia and sepsis several times, Richard and I know how this develops in him. Robert gets congested, he develops a cough and runs a fever. By this point, I have taken him to the doctor and he is put on antibiotics. His symptoms clear up but then strike again and in lightning speed his blood pressure drops, he runs another fever and he becomes weak and confused.

Because pneumonia is the culprit each time, his doctor is trying to figure out the cause. Robert has undergone testing and sees a lung specialist next month.  In the meantime, we are on the lookout for lingering pneumonia and its unwelcome companion, sepsis. 

I realize this information about sepsis may seem scary but the more information we have as caregivers, the better advocates we can be for our loved one.

Please share your experience with sepsis in the comment section.

No comments: