Sepsis Definition
Sepsis is a condition that has gained wider public attention over recent years, although in fact the illness is still not entirely understood by medical practitioners.
However, it is known that sepsis is a life-threatening condition that can cause organ dysfunction. It is therefore essential that medical practitioners recognise and treat sepsis as early as possible, as this will improve the patient's outcome.
Changing definitions of sepsis
The definition of sepsis was last revised in 2001. Since then, medical advances have led to the condition being understood in greater detail. That is why a group of medical experts recently wrote an article called 'The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)'. In this paper, they update the definition of sepsis, which until now had remained largely the same for two decades.
The article states that in lay terms, “sepsis is a life-threatening condition that arises when the body's response to an infection injures its own tissues and organs.” This means that sepsis is triggered by some sort of infection.
The body then responds to the infection, but this response is 'amplified' due to factors that are going on inside the body. That is why not everyone with an infection will get sepsis. The response sets off a series of reactions that damage the tissues and organs. A key characteristic of sepsis is organ failure.
What has changed?
This definition is very similar to what was previously known about the condition. However, there used to be a strong focus on inflammation, and it was always said that sepsis would cause widespread inflammation in the tissue. It is now accepted that sepsis can involve anti-inflammatory responses.
This means that sepsis will not always adhere to the 'systemic inflammatory response syndrome' (SIRS) that medical practitioners used to employ as a diagnostic tool. There are various criteria that indicate SIRS, and a patient that displayed two or more of these criteria was suspected of having sepsis. The article says this is no longer a useful diagnostic tool.
It also says that sepsis is not a 'continuum' that progresses to severe sepsis and septic shock. This makes the term 'severe sepsis' outdated and should be made redundant. Septic shock is a 'subset' of sepsis and is associated with a greater risk of death.
How many people get sepsis?
The NHS estimates that 100,000 people are admitted to hospital with sepsis in the UK every year. In incidence of sepsis worldwide is unknown, as many cases go unreported.
The NHS also suggests that every year in the UK, 31,000 people will die of sepsis. Those who do survive the illness may not make a full recovery. Often patients will suffer long-term physical and mental injuries that change their lives. This can range from fibromyalgia to cognitive disorders.
Diagnosing sepsis
Currently there is no set diagnostic test for sepsis. Nevertheless, there is a set of symptoms that together indicate an infection. These should lead medical practitioners to consider the possibility of sepsis. The symptoms that should prompt concern include:
- A high temperature
- Chills and shivering
- Rapid heartbeat
- Rapid breathing
As mentioned above, medical practitioners formerly identified sepsis by looking for two or more SIRS criteria. The criteria of SIRS include: altered mental state, high temperature, rapid heart rate, rapid breathing, abnormal blood glucose levels, and raised white cell count. The article says this is no longer helpful, as the SIRS criteria do not necessary indicated 'a dysregulated, life-threatening response.'
Instead, the paper says that a 'Sequential Organ Failure Assessment' (SOFA) is better placed to identify sepsis. This involves assessing certain processes and systems in the body, such as respiration, coagulation, the central nervous system, the cardiovascular system, and liver and renal function. If the patient scores two or more points, he/she has a degree of organ dysfunction and must be urgently treated for sepsis. The higher the SOFA score, the greater the risk of death.
Obtaining the results of these tests can take some time, so it is prudent to begin treatment beforehand. To determine a provisional diagnosis of sepsis, the article suggests that doctors should perform a quick Sequential Organ Failure Assessment (qSOFA) at the patient's bedside. If there is an altered mental state, systolic blood pressure of 100 mm Hg or less, and a respiratory rate of 22/min or more, the patient should be treated for sepsis immediately.
The laboratory results can then help to manage to a patient, as doctors will be able to refine the treatment accordingly.
Early recognition and treatment of sepsis
Not delaying treatment is vital because sepsis must be recognised and acted upon promptly. Even a degree of organ dysfunction can lead to the patient's death, so it is very important that there is a rapid response to sepsis.
This means that medical practitioners should quickly identify a patient who is showing signs of sepsis and begin treatment as a matter of urgency. Usually the patient will need to be admitted to the Intensive Care Unit or Critical Care Unit, as the organs may have to be supported.
Despite advances in medical care, sepsis is the main cause of death from infection across the world. Septic shock is even more serious and carries a greater likelihood of death.
To prevent sepsis deaths, and long-term sepsis complications, medical practitioners must remain wary of sepsis. They must use their professional knowledge and expertise to recognise any patient who could be suffering from sepsis and initiate an urgent response.
Sepsis and medical failings
If sepsis is quickly recognised and treated, the medical practitioners concerned will have provided a good standard of care. But sadly there are occasions when medical practitioners do not understand a patient's condition and treatment is delayed. This can be very troubling, as just a short delay can increase the risk of death or permanent disabilities.
If you or your loved one developed sepsis but their condition was not diagnosed and treated in time, please get in touch with us at Glynns Solicitors. There could be a case of medical negligence.
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