Medical officials from Bothwell Regional Health Center and Pettis County Ambulance District, local nursing homes and staff from area nursing facilities, in conjunction with the Missouri Hospital Association, have implemented an “early warning system” for sepsis, a complication of infection that leads to organ failure.
According to the University of Michigan, sepsis is defined as a severe health problem sparked by your body’s reaction to infection. When you get an infection, your body fights back, releasing chemicals into the bloodstream to kill the harmful bacteria or viruses. When this process works the way it is supposed to, your body takes care of the infection and you get better. With sepsis, the chemicals from your body’s own defenses trigger inflammatory responses, which can impair blood flow to organs, like the brain, heart or kidneys. This in turn can lead to organ failure and tissue damage.
More than 1 million patients are hospitalized for sepsis each year, more than the number of hospitalizations for heart attack and stroke combined. People with chronic medical conditions, such as pneumonia, neurological disease, cancer, chronic lung disease and kidney disease, are at particular risk for developing sepsis. Between one in eight and one in four patients with sepsis will die during hospitalization.
The Centers for Disease Control and Prevention has declared sepsis a medical emergency, reporting Tuesday that about 72 percent of patients with this fast-moving and deadly illness have recently been seen by doctors and nurses, representing missed opportunities to catch it early or prevent it.
“We’ve had educational programs here at the hospital to train our staff to look for warning signs of sepsis, what some call blood poisoning,” said BRHC Chief Medical Officer Dr. Philip J. Fracica. “We look for abnormalities in vital signs. Physicians, nurses and emergency medical personal are trained to look for sepsis warning signs such as dehydration, raised body temperature, elevated heart rate, elevated respiration and low blood pressure.Sepsis can be triggered by injury, infection or other activation of the immune response.”
One example of early sepsis detection are cards which every nurse carries behind their identification badges. These cards list key indicators of sepsis. Nurses carefully observe patients and if sepsis is suspected, doctors are notified to treat the condition with a broad spectrum of antibiotics and fluids. Blood is drawn and cultures are taken to try and isolate the kind of bacteria attacking the system. Once identified, a specific antibiotic can be administered to treat sepsis, Fracica said.
If sepsis is suspected, the treating physician will first address low blood pressure by administering fluids, ideally increasing pressure so blood will circulate to organs.
If the fluids don’t work, the doctor begins IV drugs to constrict blood vessels and raise blood pressure. The doctor then starts patients on broad-spectrum antibiotics that are likely to attack multiple organisms while awaiting culture results to reveal the actual offender. Then the doctor narrows the drug arsenal to those most likely to target the problem.
Paramedics and Emergency Medical Technicians technicians also carry a check list for sepsis symptoms. PCAD District Training Officer Eric Dirck said his staff is also equipped with portable laboratory equipment so emergency responders can draw blood and blood cultures. They also administer IV antibiotics in the field if sepsis is suspected, Dirck said.
“The key is to getting an IV line going if sepsis is suspected,” he said.
He said personnel can check lactate levels as an indicator to determining whether sepsis has started. He said all paramedics and EMTs are trained in early detection. The planning and training for the emergency medical workers began earlier this year.
These training methods are all part of the national Surviving Sepsis campaign, Dirck said.
“It’s been very effective in saving lives since the program started,” he said.
Tim Epperson can be reached at 660-530-0146.