Sepsis is a frightening diagnosis that no one wants to hear—and for good reason. Three-quarters of a million people people are diagnosed with sepsis each year, in America alone. The mortality rate (death rate) for severe sepsis is 25-30% and 40-70% for septic shock.
What is sepsis?
Sepsis is actually a complication of a severe infection, involving a systemic inflammatory response. Overall, the most common location in the body for sepsis is the respiratory system. In patients older than 65, though, the most common location is the genitourinary tract.
The American College of Chest Physicians and Society of Critical Care Medicine have defined the different stages of sepsis as including systemic inflammatory response syndrome (this is really pre-sepsis), sepsis, severe sepsis, septic shock, and refractory septic shock.
The likelihood of successful treatment is higher if sepsis is caught at an earlier stage.
Although the criteria for each stage get very technical, just reviewing the first stage gives an idea of what doctors are looking for in order to make a diagnosis. The pre-sepsis stage is called systemic inflammatory response syndrome. Patients have this if they meet two or more of these criteria: (1) body temperature greater 101.1 degrees or less than 95 degrees; (2) heart rate greater than 90 beats per minute; (3) respiratory rate of greater than 20 beats per minute, arterial carbon dioxide tension of less than 32 mm Hg, or the need for mechanical ventilation; and (4) white blood cell count of greater than 12,000 cubic millimeters or less than 4,000 cubic millimeters, or immature forms greater than 10 percent.
What are the signs and symptoms of sepsis?
Because sepsis is a systemic disease, there can be signs of it throughout the body’s various systems. This list is not comprehensive, but summarizes what you might notice, as a layperson.
In my experience in handling sepsis cases as a medical malpractice attorney, sepsis often develops in patients who are worn down from fighting a tough illness, or when an infection develops after a surgery. If you or a loved one are in such a situation and have any of these signs, be sure to describe them fully for the doctor.
Cardiac: Cold or clammy skin, low blood pressure (hypotension), poor capillary refill time, and a heartbeat that is faster than normal (tachycardia).
Constitutional: Sweating, fevers or rigors, malaise, or muscle pain. Fever is the most common initial sign of sepsis.
Dermatologic/Skin: Abscesses, cellulitis, discoloration from bleeding underneath the skin (ecchymosis), red or purple spots on the skin (petechiae).
Endocrine: Hyperglycemia (high blood sugar) or, rarely, hypoglycemia (low blood sugar). For people with diabetes, hyperglycemia is often the first sign of an infection.
Neurologic: Headache, altered mental status ranging from mild disorientation to very drowsy (lethargic) to almost comatose (obtunded).
New sepsis treatment focus
A recent study published in the New England Journal of Medicine describes how the standard treatment for patients with sepsis has changed since 2015.
To sum it up, in the decade ending in 2015, the standard treatment had gotten too complicated and focused on measures that really did not affect the outcome for septic patients. Now the consensus is to treat sepsis is with early appropriate antibiotics and lots of intravenous (IV) fluids.
Over many years of representing clients in sepsis cases, I have seen a common theme in cases involving sepsis. Quite often, doctors fail to make a timely diagnosis of sepsis, which means that the life-saving treatment is not started as quickly as it should be.
Knowing that, I was very pleased to read this comment at the conclusion of the article in the New England Journal of Medicine: “Our focus moving forward should be on recognizing sepsis early, to allow prompt administration of antimicrobials and fluids.”
Experts know that early diagnosis and treatment of sepsis increases the odds that people will recover from this serious medical problem.
We are here to help
If you or someone you care for has been seriously injured because of a delay in diagnosing sepsis or improper treatment, call 281-580-8800 for a free, no-risk consultation with a medical malpractice lawyer at Painter Law Firm.