Sepsis | Medtick
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Sepsis

What is it?

It maybe an overreaction by our body defence system when a bacterial infection is present, this reaction can occur more quickly in patients who have a weak immune system condition.

  • Sepsis is an overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure and death.
Do not wait, if one develops swollen lymph nodes, streaks on skin from injury site and feeling unwell, one may have lymphangitis, you will most likely need antibiotics. If antibiotics do not work, it may be fungal and/or viral. please let the healthcare professional know what may have caused this.
If passing no urine (not urinated/wet nappy for longer than 12-18 hours), then seek urgent medical advice as it may indicate damage to the kidneys

Diagnosis Tests

How to check if one has sepsis and what to do next.

The NEWS2 table (please see pictures) – not valid for children under the age of 16 and pregnant women and person with spinal cord injury.

One totals the points from the following parameters:

  • Please note; one has 3 points if blood pressure reading (top number)  is above 220

(Any reading where the top no. is above 140 and/or  is below 90 needs to be referred to a healthcare professional).

It takes account of:

  • Heart rate (pulse)
    • If heart beat greater than 100 beats per min it is known as tachycardia
  • Oxygen saturation (using an oximeter)
    • Scale 1 : Normal oxygen levels are 94- 98%
    • Scale 2 Chronic obstructive pulmonary disease (long term breathing condition) oxygen levels are 88-92%
    • (How to use an oximeter)
  • Respiratory rate (breaths per min)
  • Temperature (using a thermometer)
  • Level of consciousness (response to pain)
    • Alert
    • Confusion
    • Voice
    • Unresponsiveness to voice/pain
  • NEWS2 calculator and look at picture of News2 table above
    • Once one has answered the question click on ‘Evidence’ on what to do next.
If unsure on how to use this test/score please talk to a healthcare professional
Check one consciousness [Glasgow coma scale (GCS)]
The Glasgow Coma Scale is an adopted standard for assessment of impaired consciousness and coma in the acutely ill trauma and non-trauma patient and assists with predictions of neurological outcomes (complications, impaired recovery) and mortality.
  • Glasgow coma scale (GCS)
    • Max score is 15 and any change of behaviour needs to referred to an healthcare professional or if aggressive or emotionally upset as a Medical emergency.
    • Once one has answered the question click on ‘Evidence’ on what to do next.
If unsure on how to use this test/score please talk to a healthcare professional

 

Organ failure assessment (qsofa)

Patients equal to or older than 18 years old in a non-ICU setting (i.e. pre-hospital, ward, emergency department, or step-down unit) with confirmed or suspected infection.

One needs to the Glasgow coma scale (GCS) first and then:

  • qsofa
    • Once one has answered the question click on ‘Evidence’ on what to do next.
If unsure on how to use this test/score please talk to a healthcare professional

Other checks:

  • Auscultation – using a stethoscope to check for bowels movement, heart beat, and breathing of lungs
  • Palpation – touching the surface of the body with hands to check for any swelling of the organs i.e. liver, spleen, bladder
  • Percussion – Tapping the surface to evaluate the sound i.e. liver spleen, bladder

Cause

  • Any bacterial condition

Increased risk of sepsis:

Treatments

  • Person who has had surgery or any invasive procedure in the last six weeks including  caesarean section, forceps delivery, removal of retained products of conception.
  • Surgery
  • Catheter treatment
  • Chemotherapy

Medication

Illicit drugs

Pregnancy and early birth:

  • Person who is pregnant and/or had a termination and/or miscarriage in the last six weeks
  • Needed invasive procedures
  • Had prolonged rupture of membranes
  • Have or have been in close contact with people with group A streptococcal infection, for example, scarlet fever
  • Continued vaginal bleeding or an offensive vaginal discharge.
  • Early-onset neonatal infection:
    • Invasive group B streptococcal infection in a previous baby
    • Maternal group B streptococcal colonisation, bacteriuria or infection in the current pregnancy
    • Prelabour rupture of membranes
    • Preterm birth following spontaneous labour (before 37 weeks’ gestation)
    • Suspected or confirmed rupture of membranes for more than 18 hours in a preterm birth
    • Intrapartum fever higher than 38°C, or confirmed or suspected chorioamnionitis (infection within the womb)
    • Parenteral antibiotic treatment given to the woman for confirmed or suspected invasive bacterial infection (such as septicaemia) at any time during labour, or in the 24-hour periods before and after the birth (this does not refer to intrapartum antibiotic prophylaxis)
    • Suspected or confirmed infection in another baby in the case of a multiple pregnancy.

For further risk factors see below:

Symptoms

  • High temperature greater than 38°C (100°F) or over and/or chills and sweats (under three months) and/or above 39 °C (3- 6 months) or any high fever showing no interest in anything (not always present)?
  • Fever with grunting?
  • Low Temperature (below 36 degree centigrade, check three times in a 10 minute period)?
  • Cold hands and feet?
  • Looking pale and/or discoloured skin rash(not always present)- [if rash is present check with glass test (press glass cup against rash and if it does not disappear it is serious – Medical emergency)]?
  • Severe Rapid, shallow breathing (see table)?
  • Slow breathing and/or ‘catching one’s breath’ (see table/image 4)?
  • Breathing difficulties and/or short of breath?
  • High blood pressure (see table/image 4)?
  • Low blood pressure (see table/image 4)?
  • Fast or slow pulse (see table/image 4)?
  • Severe Dry cough and/or breathing difficulties?
  • Passing no urine (not urinated/wet nappy for longer than 12-18 hours)?
  • Severe general discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)-(lactate level above 2 mmol/litre if measurements available) -peron may still be alert?
  • Confusion and/or slurred speech and/or drowsiness (see table/image 4)?
  • Severe Irritated, depressed, anxiety and/or panic attacks?

For further symptoms:

Complications /Information to beware of/General tips:

Medical Emergency Condition

And/or do not, wait phone for an ambulance if have or develop:

Diagnosis Tests

How to check if one has sepsis and what to do next.

The NEWS2 table (please see pictures) – not valid for children under the age of 16 and pregnant women and person with spinal cord injury.

One totals the points from the following parameters:

  • Please note; one has 3 points if blood pressure reading (top number)  is above 220- any reading above 140, this also applies if ones blood pressure is below 90 needs to be referred to a healthcare professional).
  • Hypercapnic respiratory failure (means if you have a long term breathing condition)

It takes account of:

  • Heart rate (pulse)
    • If heart beat greater than 100 beats per min it is known as tachycardia
  • Oxygen saturation (using an oximeter)
    • Scale 1 : Normal oxygen levels are 94- 98%
    • Scale 2 Chronic obstructive pulmonary disease (long term breathing condition) oxygen levels are 88-92%
  • Respiratory rate (breaths per min)
    • Normal rates are 12- 20 breaths per min
  • Temperature (using a thermometer)
  • Level of consciousness (response to pain)
    • Alert
    • Confusion
    • Voice
    • Unresponsiveness to voice/pain
  • NEWS2 calculator and look at picture of News2 table above
    • Once one has answered the question click on ‘Evidence’ on what to do next.
If unsure on how to use this test/score please talk to a healthcare professional
Check one consciousness [Glasgow coma scale (GCS)]
The Glasgow Coma Scale is an adopted standard for assessment of impaired consciousness and coma in the acutely ill trauma and non-trauma patient and assists with predictions of neurological outcomes (complications, impaired recovery) and mortality.
  • Glasgow coma scale (GCS)
    • Max score is 15 and any change of behaviour needs to referred to an healthcare professional or if aggressive or emotionally upset as a Medical emergency.
    • Once one has answered the question click on ‘Evidence’ on what to do next.
If unsure on how to use this test/score please talk to a healthcare professional

 

Organ failure assessment (qsofa)

Patients equal to or older than 18 years old in a non-ICU setting (i.e. pre-hospital, ward, emergency department, or step-down unit) with confirmed or suspected infection.

One needs to the Glasgow coma scale (GCS) first and then:

  • qsofa
    • Once one has answered the question click on ‘Evidence’ on what to do next.
If unsure on how to use this test/score please talk to a healthcare professional

This condition may show similar symptoms to:

If so do not take a chance, phone for ambulance, seek urgent medical attention

Detailed Information

Please copy and paste any key words from the title: Sepsis in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

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