By Carol Wolfenbarger
Chief Executive Officer, Mission Hospital McDowell
In this column, I’ve talked about a range of health conditions, from diabetes to mental health, in an effort to raise awareness and explain treatment options and the recovery process. This month, I want to talk about a condition that doesn’t get a lot of attention, but that our nurses and physicians are constantly looking out for: sepsis.
This serious condition occurs when your body’s immune system goes “haywire” and grossly overreacts to infection. In a sense, the same immune system that identified and began to fight invaders actually starts to harm you, resulting in the condition we call sepsis. When unchecked, it’s a life-threatening illness. Sepsis is responsible for 1.5 million hospital stays each year, and about 250,000 deaths across the United States. On September 13, we will honor World Sepsis Awareness Day with hopes of increasing community knowledge of symptoms, treatment and recovery.
Bacterial infections are usually the cause of sepsis, and if undiscovered and untreated, it can lead to organ failure and even death. Like stroke, it’s critical to treat sepsis early before it snowballs into the worst scenario, septic shock. Some fast facts on sepsis include:
- Sepsis occurs when your immune system gets confused and hurts rather than helps you, and infection enters your bloodstream.
- High-risk groups for sepsis include the elderly, the very young, anyone with an infection, people with diabetes, patients who’ve recently had surgery and those with compromised immune systems.
- The best ways to prevent sepsis are preventing infection by frequent handwashing and keeping any surgical site clean, getting vaccinated for pneumonia and the flu (35 percent of sepsis cases stem from pneumonia), and seeking prompt treatment for a urinary tract infection.
- Sepsis symptoms can be tricky because there are so many and some accompany numerous other conditions. Here are some of the symptoms: rapid breathing or pulse, feeling disoriented, chills or fever, nausea, vomiting, or diarrhea and low body temperature.
- Treatments include administering fluids and antibiotics and, if needed, dialysis and other organ-saving steps.
Just as the signs of stroke have an acronym (BEFAST) to help people get medical help as quickly as possible, so too is there an easy-to-remember acronym for sepsis symptoms. Both are extremely time-sensitive conditions. The acronym for sepsis symptoms is “TIME,” which stands for:
T – Temperature (high or low body temperature)
I – Infection (signs include fever, shortness of breath and redness or swelling around a wound) or gastrointestinal symptoms
M – Mental decline – sleepiness or confusion
E – Extremely ill – highly uncomfortable
At Mission Hospital McDowell, we assess every patient for the signs and symptoms of sepsis on presentation to our emergency department admissions, as well as twice daily during a patient’s stay. We look for a combination of a suspected infection, as well as altered mental status, abnormal lab values or vital signs outside of the normal range. If during the screening process a patient is positive, the care plan kicks into additional lab studies. According to the screen, a CODE SEPSIS may be initiated that summons the critical care team to activate more aggressive interventions, including IV fluids and IV antibiotics – all in conjunction with our hospitalist.
We use the Rothman Index, a tool built into our Electronic Medical Record that allows us to electronically “hover” over subtle changes in patient condition. Generating data at regular intervals based on the documentation of nursing assessments, vital signs and labs, the Rothman Index serves as an early-warning system monitor for nursing.
Use of all of this technology is contingent on one thing: the patient presenting for TIME-ly treatment. Personal recognition of symptoms that may indicate a potential sepsis diagnosis and seeking treatment immediately is key. We are here to care for you – just remember, TIME-ing is everything.
Carol Wolfenbarger, MSN, RN, FACHE, is Chief Executive Officer of Mission Hospital McDowell. She holds both Bachelors and Masters of Science degrees in nursing administration from the University of Tennessee, is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives (ACHE). Carol, who has served hospitals and health systems for more than three decades, has worked to add full-time cardiology services, led growth in outpatient services including imaging and surgery, and the expansion of primary care offering in Burke County since assuming her role as President at McDowell Hospital in 2015. She is an active member in Rotary and serves as a Board member for the Rutherford/Polk/McDowell Health District Board of Directors, the Corpening YMCA Board of Directors, and the McDowell County Chamber of Commerce Board of Directors.