Signs and Symptoms of Sepsis
Recognising the signs and symptoms of sepsis is the first step towards a diagnosis. This must be achieved quickly as sepsis needs to be treated rapidly. Therefore it is vital that medical professionals have a thorough understanding of the signs of sepsis and act upon the symptoms.
Sepsis – what happens?
Sepsis is when the body over-reacts to an infection. This will not occur with every infection we develop. Instead, it happens when the immune system responds to an infection that is severe or has spread, producing inflammation across the whole body.
Ordinarily when there is an infection present in one area of the body, the immune system will send blood to that area. The blood vessels open up to let the blood – which contains clotting agents and infection-fighting antibodies – into the tissue and skin.
This response works very well if the infection is localised – i.e. is in one area of the body. But if the infection has spread or is very severe, the immune system will prompt all of the blood vessels to open up.
This will cause a number of consequences, including a drop in blood pressure and widespread clotting (which makes it difficult for the blood to travel around the body). In turn the vital organs will become deficient in oxygen and they will start to fail.
Many cases of sepsis are triggered by infections such as pneumonia, urinary tract infection and abdominal infections. However, for some patients the underlying cause will never be established. It can be something seemingly insignificant, like a cut, scratch or bite.
Symptoms of sepsis
Whatever the trigger of sepsis, the effect will be the same: the patient will rapidly become unwell.
The symptoms may be vague at first and resemble other conditions such as the flu. The symptoms will also progress as the patient becomes increasingly unwell. At first the symptoms will include:
- High temperature
- Rigors – chills and shivering
- Fast heartbeat
- Fast breathing
If a patient has two or more of these symptoms, they should be investigated for sepsis. Additionally, medical practitioners should be concerned over symptoms that persist for a long time. For instance, having rigors for a long time is indicative of a serious infection. The same is true of breathing that is persistently laboured and shallow. Difficulty breathing is not unusual in a chest infection, but if the problem continues it can signify sepsis.
As the patient deteriorates, other symptoms will appear, such as:
- Feeling dizzy and faint
- Mottled skin
- Reduced urination
- Mental confusion
- Diarrhoea, nausea and vomiting
- Muscle pain
- Slurred speech
The presence of mottled skin is a sign that the circulation of blood is being disrupted. This shows that the condition is becoming severe. The individual affected will feel extremely unwell and loved ones often say they have never seen them so ill.
Diagnosing sepsis – the clinical signs of sepsis
Medical practitioners should recognise the signs and symptoms of sepsis without much delay. Although they are very similar to other conditions, there should be an awareness of sepsis that should prompt suspicion in any patient who is displaying two or more of the aforementioned symptoms. This is particularly true if their symptoms are persistent.
There is no quick way to determine whether or not a patient has an infection. Blood samples should be taken, but microbiology tests can take around 24 hours to complete. While a diagnosis is being confirmed, a patient should be started on antibiotics immediately.
Therefore the diagnosis process depends largely upon medical professionals identifying the clinical signs of sepsis. Quick tests that will aid a diagnosis include taking a patient's temperature, listening to their heart rate and their breathing rate. Doctors should also take note of a patient's appearance and state, such as whether they have mottled skin and appear confused.
If the signs and symptoms suggest the possibility of sepsis, treatment should be started and blood cultures sent to the laboratory for further testing.
Delay in treating sepsis
Starting treatment before a diagnosis has even been confirmed may seem at odds, but it is essential where sepsis is concerned. If a patient does indeed have sepsis, it is vital that treatment is started at the earliest available opportunity because it is a fast-moving condition. A delay of just one hour in providing antibiotics can increase mortality rates.
Sepsis is associated with alarmingly high mortality rates. Every year in the UK around 37,000 people will die of sepsis every year. According to Mervyn Singer, Professor of Intensive Care Medicine at University College London, for every 100 patients admitted to intensive care with sepsis:
- 20-30% will die on the Intensive Care Unit
- 10% will not leave hospital
- 10-20% will die within one year
Despite what the high mortality rates suggest, it is possible to successfully treat sepsis. In fact, the charity the UK Sepsis Trust believes that over 12,000 sepsis deaths in the UK could be avoided with earlier treatment. The key to preventing a sepsis death is awareness amongst medical practitioners and immediate treatment. As long as doctors remain vigilant and take early action, it is possible for the patient to make a full recovery.
Doctors fail to diagnose and treat sepsis
When doctors fail to diagnose and treat sepsis in time, the consequences can be devastating. As mentioned above, sepsis develops rapidly. Within a short space of time the patient can have fallen into a critical condition. At this stage the odds are stacked against them and they may not recover from the multi-system organ failure.
Even if a patient does survive, the recovery process can be slow and frustrating, with a patient suffering both physical and physiological injuries for some time to come.
If clinicians fail to diagnose sepsis, despite the patient displaying the typical signs and symptoms of the condition, the level of care will be deemed substandard. If this causes a patient harm, as it almost certainly will do, there will be grounds for a compensation claim.
To find out more about making a sepsis claim, you need to talk to a solicitor who works in clinical negligence law. Contact us at Glynns Solicitors to speak to a lawyer today.
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