Symptoms And Treatment Of Sepsis

Discuss the magnitude of bacteremia and sepsis in hospitalized patients and the relationship between these two diagnoses. (5 points)

Is sepsis complicated by organ dysfunction, is diagnosed in more than 750,000 patients per year and has mortality rates as high as 28%-50%.

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al.,

Sepsis is a very serious condition with a high mortality rate that ranges from 28-50%. 9

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

According to information published by the Mayo Clinic, sepsis has three stages: sepsis, severe sepsis and septic shock. The mortality rate for septic shock is nearly 50 per cent, and an episode of severe sepsis increases the risk of future infections. Severe sepsis causes blood flow to the vital organs, such as the brain, heart and kidneys, to become impaired. Sepsis can also cause blood clots to form in organs and extremities such as arms, legs, fingers and toes, which can lead to organ failure and tissue death (gangrene).

Septic shock results from bacteria that multiply in the blood and then releases toxins that decrease blood pressure, thus, impairing blood flow to cells, tissues and organs. It is an acute infection, usually systemic, that overwhelms the body (toxic shock syndrome) (Huether & Mccance, 2012). This

As sepsis progresses, tissues become less perfused and acidotic, compensation begins to fail, and the patient begins to show organ dysfunction. The cardiovascular system also begins to fail, the blood pressure does not respond to fluid resuscitation and vasoactive agents, and signs of end-organ damage are evident (e.g., renal failure, pulmonary failure, hepatic failure). As sepsis progresses to septic shock, the blood pressure drops, and the skin becomes cool, pale, and mottled. Temperature may be normal or below normal. Heart and respiratory rates remain rapid. Urine production ceases, and multiple organ dysfunction progressing to death occurs. Adventitious lung sounds occur throughout the lung fields, not just in the upper fields of the lungs.

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Knapp (2012) describes sepsis as the systemic inflammatory response to a pathogen. Sepsis can be a fatal condition which occurs when the body retaliates to an infection by attacking the body’s own tissues and organs. Sepsis has many symptoms that can be attributed to other illness such as flu, which can make it difficult to recognise and treat in time (CDC Sepsis 2016). Due to this every year in the UK there are 150,000 cases of sepsis, which leads to 44,000 deaths, in perspective sepsis results in more deaths than bowel, breast and prostate cancer collectively (Sepsis Trust, 2016). Sepsis costs the NHS £15.6 billion a year (Sepsis Trust 2016). As the NMC code of conduct describes, healthcare professionals have a ‘duty of condor’ to preserve the safety of patients, reducing the potentials of harm and mistakes to the service users (NMC Code of Conduct 2015), thus with improved management and early detection of sepsis e.g. beginning a course of antibiotics within the hour of detection, will not only save the NHS £2.8 billion a year but thousands of lives (Sepsis Trust 2016).

Sepsis still represents a major cause of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. There is a lack of early diagnosis and timely intervention for sepsis in the emergency department (ED), and recent interest has focused on biomarkers for early diagnosis, risk stratification, and evaluation of prognosis of sepsis.

Once the sepsis criteria are met, the diagnosis of sepsis is added to the patient’s inpatient diagnosis, identifying the source of the infection and treatment it of it begins. Physicians, Nurses Practitioners, and Physicians assistants can order diagnostic studies such as x-rays, CT scans, MRI’s and ultrasounds, antibiotics (intravenously), and fluid therapies can all be ordered to help in treating the sepsis.

Sepsis also known as blood infection, primarily caused by bacteria is a major global healthcare problem claiming more than 600,000 infant lives, most of them in least developed and developing countries. Apart from Infants it is more common in elderly people and those with weak immune system. Sepsis occurs when the body's effort to fight an infection results in the immune system damaging tissues and organ. This chaotic response, designed to protect us, causes widespread inflammation, leaky blood vessels and abnormal blood clotting resulting in organ damage. In severe cases

Sepsis is a debilitating, potentially life threatening condition that has become a big burden on the health system worldwide. Early recognition and aggressive timely treatment have proven to be life saving interventions. South Miami Hospital (SMH) aims to provide safe care to our community by implementing and utilizing evidence –based guidelines and protocols. According to research, early identification of patients presenting with signs and symptoms of sepsis is crucial to patients’ survival. In order to achieve this goal SMH Emergency Department (ED) implemented a triage sepsis-screening tool, an intervention that as evidenced by research helps to recognize patients at risk for developing sepsis or presenting with this devastating disease.