Sepsis refers to an impaired and overwhelming whole body immune response to an insult (e.g.: infection, injury).
This extreme response is considered a life-threatening medical emergency.
According to the NIH, this condition is the leading cause of death in acute-care medical facilities.
What causes this kind of impaired and life-threatening response to infection and certain non-infectious insults?
The majority of sepsis cases are due to bacterial infections. They may also be caused by viral pathogens and fungal organisms. In addition, sepsis can result from traumatic injuries.
In most cases of infection, the body releases chemical and protein immune substances to help resolve the infection. These substances are referred to as “mediators.”
What changes in sepsis?
If these mediators continue unchecked, they have the ability to bring about widespread clotting issues, inflammation and contribute to leaky blood vessels. These systemic impacts can impair circulation, leading to organ damage.
Leading Causes of Sepsis
Sepsis occurs when an infection the patient already has triggers a cascade of reactions in their body.
The infections that most often lead to sepsis include those that start in the:
lung
urinary tract
skin
gastrointestinal tract
Sepsis Risk Factors
Which Individuals Are Most at Risk?
Some patients are considered to be more at risk for sepsis.
Healthcare professionals should be aware these patients include:
Persons aged 65 or older
Patients with weakened immune systems
Patients with chronic medical conditions;
For example:
diabetes,
lung disease,
cancer,
kidney disease
Persons who have suffered a recent severe illness or were hospitalized
Persons with a history of sepsis
Children younger than one year of age
[According to information and statistics published on the (2022) CDC and NIH websites ]
Symptoms
The most common symptoms of sepsis include: fever, sensation of chills, increased respiratory and heart rate, rash, confusion, and disorientation.
Other symptoms include:
low blood pressure
extreme pain
shivering
shortness of breath
clammy skin
Diagnostics & Testing
After thorough examination, including a history and physical, the healthcare provider may order a number of tests to further assess a patient for sepsis.
Examples of commonly ordered diagnostics are: blood tests (e.g. cultures, CBC, etc), urinalysis/C&S, cultures of wound/respiratory secretions, chest x-rays, and body scans. Other diagnostic studies may be indicated depending on the individual patient, their condition and medical history. Such testing aids providers in pinpointing the infection, identifying its location, and prescribing therapeutics.
Fundamentals of Sepsis Treatment
Patients with sepsis typically receive treatment in the ICU.
Healthcare professionals will work to fight and attempt to resolve infection; protect organ function; and curb any drop in the patient’s blood pressure.
Typical patient care almost always involves anti-infective medications (e.g.: antibiotics) and IV fluids.
Very sick patients may also require intubation to support breathing and oxygenation. Some infections or injuries may necessitate surgical intervention. Especially ill patients could even require dialysis.
Medications
There are many medications used to treat sepsis and septic shock. The healthcare provider will determine which ones are the right choice for a particular patient, dependent on their individual needs:
Antibiotics
Broad-spectrum antibiotics
After testing, an anti-infective that is specific to the patient’s needs may be ordered
Vasopressors
Corticosteroids
Insulin (assists in stabilizing blood sugar levels if elevated)
Pain medications
Sedatives
Knowledge Check
Concept Review Questions
1.) The most common symptoms of sepsis include:
(Select all that apply)
a. fever
b. sensation of chills
c. increased respiratory and heart rate
d. rash
e. all of the above
2.) Healthcare professionals should be aware that certain patients are more at risk for sepsis. Which patient profile is directly associated with an increased risk for sepsis?
a. Jim, a 35 year old male with no history of sepsis
b. Jane, 18 years old with a history of astigmatism
c. Jay, an 11 month old infant with a history of pneumonia
d. None of the above
(See answers below)
Answers:
1.)
e. all of the above
Why?
Remember signs and symptoms include:
The most common symptoms of sepsis include: fever, sensation of chills, increased respiratory and heart rate, rash, confusion, and disorientation.
Other symptoms include:
low blood pressure
extreme pain
shivering
shortness of breath
clammy skin
2.)
c. Jay, an 11 month old infant with a history of pneumonia
Why?
Remember who is most at risk according to the CDC/NIH:
Persons aged 65 or older
Patients with weakened immune systems
Patients with chronic medical conditions;
For example:
diabetes,
lung disease,
cancer,
kidney disease
Persons who have suffered a recent severe illness or were hospitalized
Persons with a history of sepsis
Children younger than one year of age
Disclaimer:
The above study guide is not intended to be used as medical advice. The above study guide represents study materials, always seek and follow the advice of your medical provider for any acute or chronic medical issues or questions.
Reference Source Material:
Centers for Disease Control and Prevention
NIH
National Center for Emerging and Zoonotic Infectious Diseases