September is Sepsis Awareness Month

World Sepsis Day takes place on Sept. 13, giving hospitals and health care professionals an opportunity to draw attention to this deadly but often preventable medical condition. Carmencita Agcaoili, MD, the medical director of Critical Care at Washington Hospital, is passionate about the prevention and treatment of sepsis. “If caught early and treated correctly, in most cases a patient can fully recover,” she says.

Sepsis arises when the body’s response to an infection accelerates to a dangerous degree, severely damaging tissue and organs. Defined as a life-threatening organ dysfunction, sepsis can lead to shock, organ failure, and death if left untreated. The original infection may be an unremarkable bacterial or viral infection that is typically treated at home. Bacterial infections such as a skin boil, mouth abscess, and bladder infection, or viral infections such as the flu or COVID-19 can all trigger the chain reaction that leads to sepsis. The Centers for Disease Control and Prevention (CDC) report that nearly 87% of sepsis cases start before a patient goes to the hospital. Each year at least 1.7 million adults in the United States develop sepsis.

“Most infections do not lead to sepsis. However, once an infection turns septic, time is of the essence for treating the condition. Sepsis is always a medical emergency,” warns Dr. Agcaoili. “That is why it is important to know the signs and symptoms of sepsis.” A person with any sort of underlying infection who exhibits one or more of the following symptoms should seek medical advice and treatment immediately.

Signs and symptoms of sepsis

• Fever, shivering, or feeling very cold
• Extreme pain or discomfort
• Decreased appetite and/or vomiting
• Shortness of breath
• Clammy or sweaty skin
• High heart rate or weak pulse
• Confusion or disorientation

While there are individuals with heightened risk factors for sepsis, Dr. Agcaoili says that anyone can develop the condition. “Don’t think that just because you are young and healthy that you cannot get sepsis. If you are experiencing any of the signs or symptoms of sepsis, you should be evaluated by a doctor as soon as possible. For those who contract sepsis, the chance of mortality increases 8% for every hour treatment is delayed.”

People who have a higher risk for sepsis include individuals with weakened immune systems and chronic medical conditions such as diabetes, lung disease and cancer. Adults over 65 and children younger than 1 are also at higher risk.

Once contracted, sepsis can progress rapidly from severe sepsis to septic shock,

where blood pressure drops dramatically and multiple organs shut down. Washington Hospital follows strict protocols, called treatment bundles, for treating patients with sepsis. The treatment bundles include the rapid administration of antibiotics and fluids, blood tests, and monitoring. Additional treatment typically includes stress-dose steroids, oxygen, and vasopressors, which are drugs that elevate blood pressure when it has dropped too low. In Critical Care, a patient may also be placed on mechanical ventilation and dialysis.

For centuries, sepsis was known as “blood poisoning” and little was understood about what caused it or how to treat it. The discovery of antibiotics in the early 20th century was a significant milestone in combating underlying infections, but the management of sepsis itself remained challenging. The coordination of a systematic response to sepsis worldwide did not begin until the early 2000s. In 2003, the international “Surviving Sepsis Campaign” (SSC) released standardized, evidence-based guidelines for the management and treatment of sepsis and septic shock with the aim of reducing the number of deaths. Over the next 10 years, targeted care bundles were developed that significantly improved treatment outcomes around the globe.

“Washington Hospital was one of the earliest adopters of the sepsis bundles and protocols,” says Dr. Agcaoili. “The Hospital’s Sepsis Committee, a multidisciplinary team of physicians, nurses, and hospital pharmacists, has been implementing and monitoring the bundles since 2008. We have rapid response nurses at the Hospital around the clock who have specialized training in implementing the sepsis care bundles. Once we have a high clinical suspicion that a patient has sepsis, a rapid response nurse is available to coordinate the patient’s screening and treatment. Over the last decade and a half, the rate of survival from sepsis and septic shock has greatly increased as a result.”

“It cannot be overstated; sepsis is a medical emergency,” urges Dr. Agcaoili. “Patients can help reduce their risk of sepsis and septic shock by being vigilant. Simple steps like washing hands regularly with soap and water can help prevent the spread of harmful bacteria. Staying up to date on vaccinations can also provide protection from infections that could lead to sepsis. But most importantly, people need to know the symptoms of sepsis, and act fast to seek medical care if there is any suspicion that their infection has become septic.”

To learn more about sepsis, Washington Hospital Healthcare System’s InHealth video, “The Signs and Symptoms of Sepsis,” features several medical experts on the topic https://www.whhs.com/video-center/inhealth/the-signs-and-symptoms-of-sepsis/. Additional information can be found on the CDC’s website at https://www.cdc.gov/sepsis/index.html.