Emergency and Urgent Care - Sepsis

What is sepsis?

Sepsis is the body's abnormal or improper response to an infection. Infections are common and many people recover from them without any complications. The majority of people with an infection will not feel well but will improve without developing sepsis. However, any infection, even a mild one could turn into sepsis.

Sepsis can happen because of any type of infection but is seen commonly in bacterial infection such as chest infections or pneumonia, meningitis or brain infection, and urinary tract infections. Sepsis can be potentially life threatening and diagnosing it quickly and providing management is essential. However, if it is identified and treated early, the outcome can be good.

It is important to look for the key signs that show sepsis might be developing and seek help early.

Who is more at risk of sepsis?

Anyone can develop infection which may develop into sepsis. It is not clear why some people develop sepsis in response to an infection and others don’t, but some patient groups are at particular risk of sepsis:

• Children and young adults
• Pregnant people and people who have given birth recently
• Older people, especially people over the age of 75
• People with diabetes
• People who are diagnosed with conditions affecting their immune system strength or might be on some kind of medications that may lower their immune system functionality

How does sepsis start and what causes it?

Sepsis starts with an illness relating to a particular infection and has various symptoms depending on type and source of infection.  Generally, sepsis can give the following symptoms:

• Feeling hot or cold
• Feeling shivery
• Feeling generally unwell and very tired
• Dizziness
• Confused
• Pale blotchy or blue skin
• Poor appetite
• Nausea or vomiting
• Rapid heartbeat
• Fast or shallow breathing

Sepsis can give specific symptoms depending on source of infection, such as:

•    Difficulty breathing
•    Chest pain
•    Cough
•    Fever
•    Urinary symptoms
•    Rash that doesn’t go away when you roll a glass over it
•    Bad headache
•    Area of red-hot skin
•    Swollen wound
•    Tummy pain
•    Painful joints

When should I seek help?

It is very important to seek early help either from your GP or visit the emergency department if you have the symptoms or if you feel unwell. Timely management saves lives.

How is sepsis diagnosed and treated?

Sepsis is a medical diagnosis and requires a full clinical assessment. Life-saving treatment is relatively simple and if administered quickly can often prevent deterioration.

Treatment will include:

• Antibiotics and fluids administered into a vein through a drip
• You may need extra oxygen
• Frequent blood tests and monitoring of your vital signs (such as blood pressure and heart rate) are required to monitor your progress
• Tests will be performed to find the source of the infection and check the antibiotics being given are the right ones for that infection. Antibiotics are essential for the treatment of sepsis and are monitored to prevent development of resistant germs

Sepsis can often be safely managed on a ward or high care area of the hospital. However, if there are signs that the vital organs are deteriorating, you may need to be treated in the Critical Care Unit. Here you will be continuously monitored by highly trained doctors and nurses and many other staff. Extra treatment required to keep your organs functioning can be provided, such as drugs to support your blood pressure, breathing and support for your kidneys if necessary. Sepsis can cause organ damage and may require organ support in such cases, which maybe short term, long term or over a lifetime.

Recovery after sepsis

If you have been diagnosed and treated for sepsis you may continue to be affected by this for some time afterwards. You have been very poorly, and it will take time to recover. You may be affected both physically and emotionally after you go home. The after affects may last days, weeks or even months. These affects may get better by themselves over time or you may find you need extra support from your doctor to help with the recovery.

Common problems following sepsis

Long term effects are referred to as post sepsis syndrome and can include:

• Feeling tired and lethargic, with difficulty sleeping
• Lack of appetite
• Getting ill more often
• Changes in mood, including anxiety or depression
• Flashbacks
• Post-traumatic stress disorder

These symptoms usually get better by themselves over time. There can be symptoms of difficulty exercising or breathing, difficulty remembering things or concentrating or even feeling confused. Giving yourself time, gentle exercise, seeking support, making changes to working hours or work environment, trying to eat little but often helps with recovery.

Please seek help if you have any persisting trouble or concerns.

As a relative or a friend, what can I do to help?

It can be very upsetting to see your relatives so unwell. Ask the medical or nursing staff questions so that you understand what is happening and what treatment is being given. When your relative comes home, they will need extra support for several months. They may be anxious, and it may help to talk together about what has happened. They may not remember all of it and you can help to put things in place for them. You may all need some support for a while, so take extra help offered from friends and relatives. Take your relative to the GP if necessary.

Will I get sepsis again?

People who have had sepsis soften worry about it happening again. Research shows that during recovery, some people are more likely to get infections, which can increase the risk of sepsis. If sepsis happens again, it is usually because of a new infection.
This infection may develop in the same part of the body as before – sometimes by chance, but it could also be due to an underlying health condition. Occasionally in some cases, sepsis may return if the original infection was not fully treated.

Further information and support

Speak to you GP or healthcare professional if you need any advice or if you are concerned

Oldham, Bury and Rochdale - 0161 624 0420
Salford - 0161 789 7373

Visit NHS UK websites and find answers for many of your queries
Call NHS 111
www.nice.org.uk
Visit The Sepsis Trust UK for support

The UK Sepsis Trust
For more information and support relating to Sepsis, severe infection and critical illness please visit
www.sepsistrust.org/get-support/ or phone the support team on 0808 800 0029 (UK number).