Hospital News

September WMHS Population Health Focus: Sepsis

Sepsis is a clinical syndrome that is caused by a biological response to an infection, which can lead to tissue damage, organ failure, and death. Over 1 million cases of sepsis occur each year in the United States.

Western Maryland Health System has a system-wide and community-wide campaign to improve patient safety and our quality of care by improving our sepsis outcomes. In collaboration with the Maryland Patient Safety Center and the Maryland Hospital Association Improving Sepsis Survival campaign, our goal is to reduce our mortality rates from Sepsis through improved early recognition and treatment.

WMHS has a multi-disciplinary team that includes Medical Staff, Nursing, Respiratory, Pharmacy, Laboratory and any other related disciplines that have an impact on our Sepsis outcomes.

“Early recognition of sepsis is the single most important thing,” said Dr. Rameet Thapa in the Infectious Disease Department at WMHS.

A patient’s treatment plan consists of initial resuscitation which includes intravenous fluids as well as empiric antibiotic therapy. Providers will order investigations to identify the source of the infection based on the clinical symptoms.

While most sepsis cases at WMHS begin before the patient has arrived at the hospital, staff is charged with knowing the symptoms in order to intervene as early as possible. “The sooner you act, the better outcome you can expect,” Dr. Thapa said. “We want to catch sepsis early. The body is trying to fight the infection and our role is to provide aid in that fight.”

CDC Declares Sepsis A “Medical Emergency.”

The Centers for Disease Control and Prevention released a report declaring sepsis a medical emergency because many physicians and nurses miss the early signs of the condition. In a statement, CDC Director Tom Frieden said, “When sepsis occurs, it should be treated as a medical emergency.”

Many cases of sepsis could be recognized and treated long before it causes severe illness or death, according to the CDC report. CDC researchers found that around 70% of patients with sepsis had used health care services recently or had chronic diseases that required regular medical care, which presents opportunities for the condition to be identified early.

Sepsis Awareness Month – Fast Facts

What is sepsis? 

Sepsis is an illness that affects all parts of the body that can happen in response to an infection and can quickly become life-threatening. In severe cases of sepsis, one or more organs fail. In the worst cases, sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. Once this happens, multiple organs may quickly fail and the patient can die. Sepsis is a serious illness that is very difficult to predict, diagnose, and treat. Patients who develop sepsis have an increased risk of complications and death and face higher healthcare costs and longer treatment.

What causes sepsis?

Sepsis is a response to an infection. When you get an infection, your immune system releases chemicals into your blood to fight the infection. The chemicals sometimes cause body-wide inflammation, which can lead to blood clots and leaky blood vessels. This impairs blood flow, which damages the body’s organs by depriving them of nutrients and oxygen. Different types of infections can lead to sepsis, including infections of the skin, lungs, urinary tract, abdomen (such as appendicitis), or another part of the body. Healthcare-associated infections, including pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and surgical site infections can sometimes lead to sepsis. MRSA infections of the skin and soft tissue can also lead to sepsis.

Who gets sepsis?

Anyone can get sepsis, but the risk is higher in:

  • people with weakened immune systems
  • infants and children
  • elderly people
  • people with chronic illnesses, such as diabetes, AIDS, cancer, and kidney or liver disease
  • people suffering from a severe burn or physical trauma

How many people get sepsis? 

CDC’s National Center for Health Statistics estimates that, based upon information collected for billing purposes, the number of times people were in the hospital with sepsis or septicemia (another word for sepsis) increased from 621,000 in the year 2000 to 1,141,000 in 2008.
1 – Between 28 and 50 percent of people who get sepsis die.
2 – The number of cases of sepsis each year has been going up in the United States. This could be because of the following reasons:

  • the population is aging
  • people have more chronic illnesses
  • people are getting more invasive procedures, immunosuppressive drugs, chemotherapy, and organ transplants
  • increasing antibiotic resistance
  • increasing awareness and tracking of sepsis

What are the symptoms of sepsis?

Common symptoms of sepsis are fever, chills, rapid breathing and heart rate, rash, confusion, and disorientation. Many of these symptoms, such as fever and difficulty breathing, are the same as in other conditions, making sepsis hard to diagnose in its early stages.

How is sepsis diagnosed?

Doctors diagnose sepsis using a number of physical findings like fever, increased heart rate, and increased respiratory rate. They also do lab tests that check for signs of infection.

How is sepsis treated?

People with sepsis are usually treated in hospital intensive care units. Doctors try to treat the infection, sustain the vital organs and prevent a drop in blood pressure. Doctors prescribe antibiotics to treat the infection. Many patients receive oxygen and intravenous (IV) fluids to maintain normal blood oxygen levels and blood pressure. Other types of treatment, such as mechanical ventilation or kidney dialysis, may be necessary. Sometimes surgery is required to clear a local site of infection. Many other drugs, including vasopressors and corticosteroids, may be used to treat sepsis or to revive those who have gone into septic shock.

Are there any long-term effects of sepsis?

Many people who survive severe sepsis recover completely and their lives return to normal. But some people, especially those who had pre-existing chronic diseases, may experience permanent organ damage. For example, in someone who already has kidney impairment, sepsis can lead to kidney failure that requires lifelong dialysis.

CDC Declares Sepsis A “Medical Emergency.”

The Centers for Disease Control and Prevention released a report declaring sepsis a medical emergency because many physicians and nurses miss the early signs of the condition. In a statement, CDC Director Tom Frieden said, “When sepsis occurs, it should be treated as a medical emergency.”

Many cases of sepsis could be recognized and treated long before it causes severe illness or death, according to the CDC report. CDC researchers found that around 70% of patients with sepsis had used health care services recently or had chronic diseases that required regular medical care, which presents opportunities for the condition to be identified early.

SEPSIS: Quicker Diagnosis = Better Outcomes

If you or a loved one for has two of these warning signs, seek immediate medical attention

  • Probable or confirmed infection
  • Fever above 100.4 F or below 95F.
  • Respiratory rate higher than 20 breaths a minute
  • Heart rate higher than 90 beats a minute
  • Altered Mental Status

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