World Sepsis Day – A Blog by Critical Care Nurse Lisa White

Hello, my name is Lisa White, and I am a qualified Critical Care Nurse with 14 years of experience working within intensive care. I work within the Medical and Surgical Consumables category team. For World Sepsis Day on 13 September, I wanted to highlight the importance of recognising the signs and symptoms of sepsis, as early intervention is key. In my career, I have seen the devastating consequences sepsis has on both patients and families. If not spotted and treated quickly, it can rapidly lead to organ failure and death.

In my previous role during a conference, I was lucky enough to meet Tom Ray, a survivor who lost all four limbs due to sepsis. Tom and his wife Nic talked about their experience and his journey back to health.

See our Useful Links section to read about Tom’s story.

There are 47-50 million cases of sepsis worldwide every year and at least 11 million deaths per year worldwide.

The number of people developing sepsis is increasing, with around 123,000 cases each year in England. An estimated 37,000 deaths are associated with the condition.  To put this into context, sepsis now claims more lives than lung cancer, the second biggest cause of death after cardiovascular disease.

80% of sepsis cases arise in the community and yet a large proportion of the public do not recognise the symptoms, which can lead to a delay in treatment. 40% of sepsis cases are children under five years old.

1. The very young (under one year) and older people (over 75 years), or people who are very frail.

2. People who have impaired immune systems because of illness or drugs, including:

• People having treatment for cancer with chemotherapy.
• People who have impaired immune function (for example, people with diabetes, people who have had a splenectomy, or people with sickle cell disease).
• People taking long-term steroids.
• People taking immunosuppressant drugs to treat non-malignant disorders such as rheumatoid arthritis.

3. People who have had surgery, or other invasive procedures, in the past six weeks.

4. People with any breach of skin integrity (for example, cuts, burns, blisters or skin infections).

5. People who misuse drugs intravenously.

6. People with indwelling lines or catheters.

Seek medical help urgently if you (or another adult) develop any of these signs:

• Slurred speech or confusion
• Extreme shivering or muscle pain
• Passing no urine (in a day)
• Severe breathlessness
• It feels like you’re going to die
• Skin mottled or discoloured

If you spot any of the above signs, call 999 or go straight to A&E and just ask: “Could it be sepsis?”

A child under five may have sepsis if he or she:

• Is not feeding
• Is vomiting repeatedly
• Has not passed urine for 12 hours.

If you spot any of the above signs, call 111 or see your GP and just ask: “Could it be sepsis?”

Sepsis is the number one cause of:

• Death in hospitals
• For hospital readmissions
• Healthcare cost.

We provide many types of equipment to help diagnose and treat sepsis both in the hospital and community setting. The list below demonstrates how many products are potentially required to nurse a patient with sepsis. This list is not exhaustive (there are many more) and shows that the products we provide are so important in the treatment of sepsis.

For initial treatment

• Oxygen masks and tubing- to keep O2 saturations >94%.
• IV cannula- to administer fluids and IV antibiotics.
• Blood collection bottles- to collect blood samples for testing.
• Specimen bottles- to collect urine, sputum and blood for cultures.
• IV giving set- to administer fluids and IV antibiotics.
• IV Pump- to administer fluids and IV antibiotics
• Urinary catheter and collection bag- to monitor urine output.
• Blood pressure monitor and cuff- to regularly check BP and heart rate.
• Thermometer- to monitor temperature.
• Wound swabs- for culture if a wound is present.

For serious cases in Intensive Care

• Apron- for personal protection during medical procedures.
• Stethoscope- to listen to the persons chest for any abnormalities.
• Endotracheal tube, ET tube securing device, catheter mount, ventilator tubing, HME filter, Humidification and ventilator- to mechanically take over the person’s breathing.
• Suction catheters, tubing, suction liner- to manually remove sputum from the airways.
• Nasogastric tube, giving set and NG feeding pump-to ensure nutrition.
• Arterial line, pressure transducer, pressure infuser and IV fluid- to ensure constant arterial blood pressure reading and to take regular blood samples.
• Central venous line, pressure transducer, pressure infuser and IV fluid- for central access and to deliver potent IV medications.
• Patient monitor and cables- to continuously monitor and display Heart rate, blood pressure, central venous pressure, temperature, respiratory rate and blood oxygen saturation levels.
• Kidney hemofiltration- vascular catheter, drape, skin cleaning fluid, gloves, surgeons’ gown, gauze swabs, fluid bags, consumables for machine, and anti-coagulant- to take over the work of the kidneys and to ensure all waste products are filtered from the blood.
• Urinary catheter, basic procedure pack, urinary collection bag- to monitor fluid output (if not requiring hemofiltration).
• Ultrasound machine, probe overs and ultrasound gel- to ensure correct placement of IV lines.
• Gauze, mouth sponges, saline drops, vaseline- for eye and mouth care to ensure protection and comfort.
• Pen torch – to monitor Glasgow coma scale.
• Antibacterial wipes – to damp dust bed space to ensure cleanliness.

See our Useful Links section for more information on sepsis and World Sepsis Day.

How to spot sepsis in adults?

Seek medical help urgently if you (or another adult) develop any of these signs:

How to spot sepsis in children?

A child may have sepsis if he or she: