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Understanding Sepsis 17.10.023 at 8pm @Lwnurses #LWN #LearnWithNurses Una O’Connor RGN PGCE PGDip MedEd Operations Manager, Smart Health Solutions @unasnewsSepsis is a medical emergency that requires urgent attention and rapid treatment for survival. Sepsis can be treated and, in many instances, lives are saved by using existing and proven protocolsRisk factors for sepsis include: •Infants (under one year of age) and older people (over 75 years of age). •People who are very frail. •People who are immunocompromised due to a co-morbid condition (such as diabetes mellitus, HIV, cirrhosis, sickle cell disease, or asplenia). •People who are immunosuppressed due to drug treatment (such as anticancer treatment, oral corticosteroids, or other immunosuppressive drugs). •People who have had trauma, surgery, or other invasive procedures in the past six weeks. •People with any breach of skin integrity (for example cuts, burns, blisters, or skin infections). •People who misuse intravenous drugs or alcohol. •People with indwelling lines or catheters. •Women who are pregnant, are post-partum, or have had a termination of pregnancy or miscarriage in the past six weeks [Gauer, 2013; Gotts, 2016; Singer, 2016; Rhodes, 2017; Cecconi, 2018; NICE, 2019]Examine the person to assess for: • General appearance, level of consciousness and cognition. • Temperature. • Heart rate, respiratory rate and signs of respiratory distress, and blood pressure. • Capillary refill time and oxygen saturation (abnormal results may indicate poor peripheral perfusion). • Mottled or ashen skin; pallor or cyanosis of the skin, lips or tongue; cold peripheries. • A non-blanching rash which may suggest meningococcal disease. • Weak high-pitched or continuous cry (in children under 5 years of age). • Any breach of skin integrity (for example cuts, burns, or skin infections) or other skin signs suggesting infection, such as erythema, swelling or discharge at a surgical site, or wound breakdown • Dry mucous membranes or other signs of dehydration. • The possible underlying source of infectionUse a sepsis risk stratification tool to assess the risk of clinical deterioration including severe illness or death from sepsis, depending on the person's age, risk factors, and clinical features of concern. Possible tools include: • Royal College of Physicians National Early Warning Score (NEWS) 2 for non-pregnant adults. • NICE risk stratification tool for children under 5 years or UK Sepsis Trust GP Paediatric Sepsis decision support tool for children under 5 years . • NICE risk stratification tool for children aged 5–11 years or UK Sepsis Trust GP Paediatric Sepsis decision support tool for children aged 5–11 years. • NICE risk stratification tool for adults, children and young people aged 12 years and over or UK Sepsis Trust GP Sepsis decision support tool for non-pregnant adults and young people aged 12 years and over . • UK Sepsis Trust GP Maternal Sepsis decision support tool for women who are pregnant or up to 6 weeks postpartum . Source: Assessment | Diagnosis | Sepsis | CKS | NICENICE guidance: Specialist assessment and management in an acute hospital setting involves implementation of the UK Sepsis Trust 'Sepsis Six' bundle within the first hour following recognition of sepsisComplications: Sepsis Stats Every year 48,000 people die in the UK from Sepsis Nearly 80,000 people each year suffer life-changing after-effects 11 Million deaths globally every year among 49 million cases 70% of sepsis cases develop within primary care‘Improving the understanding and awareness of sepsis among healthcare professionals and students will help to reduce the global burden of sepsis.’ Schlapbach, L.J., Kissoon, N., Alhawsawi, A., Aljuaid, M.H., Daniels, R., Gorordo-Delsol, L.A., Machado, F., Malik, I., Nsutebu, E.F., Journal of Physiology-Lung Cellular and Molecular Physiology, 319(3), pp.L518-L522.ading cause of morbidity and mortality. American Summary: How to spot sepsis in adults Slurred speech or confusion Extreme shivering or muscle pain Passing no urine (in a day) Severe breathlessness It feels like you’re going to die Skin discoloured or mottledSeek advice for any child who: 1. Is breathing very fast 2. Has a ‘fit’ or convulsion 3. Looks mottled, bluish or pale 4. Has a rash that does not fade when you press it 5. Is very lethargic or difficult to wake 6. Feels abnormally cold to touch Any child under 5 who: 1. Is not feeding 2. Is vomiting repeatedly 3. Hasn’t had a wee or wet nappy for 12 hours