By Karen S. Gorby, RN, MSN, MBA, CENP, FACHE
The human body is amazingly designed — when working well, its many systems and the organs they serve work in exquisite concert with each other. They help us do everything from processing outside stimuli to digesting food, from facilitating growth to delivering nutrient-rich blood to and from our cells and throughout our immune system, which, when working properly, is ever-ready to fight invaders.
Jeanie Bollinger, MSN, RN, ACCNS-AG, CCRN-K, works at Mission Health as an Acute Care Clinical Specialist and is not only versed in the signs and symptoms of sepsis, she has treated many patients with sepsis. “Basically, sepsis is your body’s overactive and toxic response to an infection, and the danger with sepsis is its ability to escalate very rapidly,” she explains. She adds that when sepsis transitions into the serious, life-threatening condition of septic shock, which is when the organs begin to shut down and a patient experiences serious health crises, from respiratory failure to nosediving blood pressure.
Although some groups are at higher risk for sepsis, such as the very young and very old, those with compromised immune systems and the many individuals who take a type of prescription medications called biologics, which alter how the immune system functions, it can affect anyone. “Sepsis is an equal opportunity killer,” declares Bollinger. “It strikes whether you’re rich or poor, young or old, healthy or living with a chronic illness.”
“It all begins with an infection, and it doesn’t have to be severe,” says Bollinger, “which is why we should be adamant about whether we’re at risk for infection, and an infection means anything from a small cut on the skin to a respiratory infection like pneumonia.” In fact, pneumonia is the No. 1 cause of sepsis, and urinary tract infections come in second — yet another good reason for both children and adults to keep current with their vaccines.
The It’s About Time™ campaign is a nationwide initiative to educate the public about the dangers of sepsis and why it’s critical to get care as soon as possible. An easy-to-remember acronym that clinicians use to educate their patients about the top sepsis symptoms is TIME: T points to a lower or higher than normal temperature, I is for knowing how to identify an infection, M connotes mental confusion and E stands for extreme illness, that is, the patient generally feels terrible and might be suffering severe symptoms such as respiratory distress and much discomfort. Another symptom Bollinger shares that she has seen frequently is when a patient’s skin becomes mottled and blue, often in the knees. “It’s good to try to remember that if anything is different from someone’s baseline vital signs, exhaustion level or alertness, it’s best to seek medical treatment,” she says.
Bollinger stresses that early detection can’t be emphasized enough in terms of preventing the serious trajectory of sepsis symptoms, and markedly improving the chances of survival. “The challenge with sepsis is that it’s subtle at first, and then it morphs suddenly, making your immune system turn on itself instead of fighting infection as it should. This is why we’re trying to talk to patients about sepsis so that if they end up in their doctor’s office or the emergency department, they can say to their caregiver ‘Could it be sepsis?’” The double layer of awareness means that both patient and provider are on alert, and a patient’s chances of being diagnosed at a later stage is reduced. “Simply put,” says Bollinger, “if you don’t have an infection, you can’t get sepsis.”
Fortunately, across Mission Health, and here at AMC, every patient who comes to the emergency department or is an inpatient is screened for sepsis upon entrance and throughout their hospital stay. Sophisticated processes have been developed for screening and monitoring, many of which involve medical technology that works constantly in the background to monitor patients’ vital signs. “If a patient screens positive for sepsis,” explains Bollinger, “we have automated lab data that assists the provider in identifying subtle signs of organ dysfunction, before a patient’s blood pressure crashes, for example. It’s an important complement to the provider’s own assessment.”
We at AMC also urge community members not to wait if they have any of the symptoms of sepsis, including during this time of COVID-19. Angel Medical Center remains one of the cleanest and safest places you could possibly be, and safety precautions remain in place to protect patients and staff.
Set a goal for this month to have a conversation with a friend, family member or your provider about sepsis. Any case that can be prevented means a potential life saved.
In closing, I want to remind you to stay safe. COVID-19 continues to be present, and it is important that we continue to practice social distancing, wearing a mask and washing our hands.
Karen S. Gorby, RN, MSN, MBA, CENP, FACHE, is Chief Executive Officer and Chief Nursing Officer of Angel Medical Center.