Remaining one of the most common and devastating conditions known to modern medicine, sepsis is a disease that has significant healthcare implications across the world and right here in the United States. By some estimates, this condition actually causes more deaths than prostate cancer, breast cancer, and HIV/AIDS combined each year! Overall, the cost of public contraction of sepsis costs the healthcare industry nearly $17 billion annually. Sepsis awareness
Although most nurses recognize that sepsis can be fatal, it’s not always the case that individuals are fully aware of the early warning signs and the appropriate measures to take. Like most medical emergencies and serious illnesses, early assessment and prompt treatment can improve someone’s long-term outcomes. This makes it absolutely critical to increase sepsis awareness for nurses and others in the healthcare industry.
Sepsis Awareness for Nurses
Considering that September is Sepsis Awareness Month, now is as good of a time as ever to really talk about the role of nurses in the fight against this dangerous condition. First, it’s important to understand the progression of this condition in general terms.
Systematic Inflammatory Response Syndrome (SIRS)
As the first stage to someone developing sepsis, SIRS is a clinical syndrome that can be the result of complications with surgery, trauma, myocardial infarction, pancreatitis, or burn injuries. Essentially the body works to treat serious infections as a result of these complications, presenting at least two of the following:
- Systemic inflammation
- Body temperature above 100.4º F or below 96.8º F
- Heart rate faster than 90 ppm
- Respiratory rate faster than 90 beats/minute
- Partial pressure of arterial carbon dioxide (Paco2) below 32 mm Hg
- White blood cell count above 12,000 cells/mm3 or below 4,000 cells/mm3, or greater than 10% immature (band) forms.
It’s important to note that patients can still have SIRS even without developing clinical sepsis and this condition can present serious medical complications nonetheless.
So, What is Sepsis?
When a patient meets criteria pertaining to SIRS in response to a known infection source such as bacteria, a parasite, virus, or type of fungus, they have contracted sepsis. Severe forms of sepsis occur after a patient develops acute organ dysfunction, wither hypoperfusion, and tissue hypoxemia. Most commonly, the organs affected by severe sepsis include the kidneys, lungs, heart, and blood vessels. Sometimes neurologic or hepatic dysfunction may be the primary complications a patient will experience.
At this point, the patient may go into septic shock — also called distributive shock — where they will experience a loss in core circulation in addition to poor circulatory support. This causes one’s blood pressure to drop, their body to produce less urine, and fluctuations in internal temperature. If not detected and treated early, this can quickly result in multi system failure and death.
Common Sepsis Risk Factors
Although it can happen to anyone, sepsis is more common in children and the elderly. Additionally, postoperative patients are 10 times more likely to die following complications from sepsis than other risk factors like myocardial infarction or stroke. Patients dealing with the following also have an increased risk of contracting sepsis:
• Poor Nutrition
• Long-term use of immunosuppressive therapies
• Immunosuppressive disease like HIV/AIDS
• Chronic illnesses, such as diabetes and cardiovascular disease
Where Nurses Come In
Identifying the signs and symptoms of sepsis is absolutely critical for all nurses. Some of the main assessments will include slight changes in oxygenation, heart rate, tissue perfusion, and mental status. In many cases, oxygenation changes are some of the earliest indications of a patient’s deterioration into septic shock. Soon to follow is an extreme change in heart rate along with organ failure.
Nurses will also want to monitor a patient’s urine output which can be an indicator of complications with the kidneys. Administering antibiotics, hydration, and encouraging rest are good ways to intervene in the early stages of sepsis. Working alongside other healthcare team members, nurses can take a proactive role in the prevention of this condition. Encourage others to increase their sepsis awareness this September!