Sepsis - be aware of the six symptoms to look out for

Dr Mark Porter feels sepsis (blood poisoning) tops his list of nasty diseases. It has a comparatively low profile. In an article in the Times on Tuesday 24th April 2018 he highlighted the need to be aware of the sepsis symptoms.
Times article


What is sepsis?
Sepsis, also known as blood poisoning, is the reaction to an infection in which the body attacks its own organs and tissues.
For more information on sepsis visit sepsistrust.org

FAST
See our earlier note on another of Dr Mark Porter's articles on recognising the signs of a stroke and how the FAST reminder can help you. More

Posted: 180425, updated 180427
"Time is of the essence" is an oft-used cliché in medicine, but with sepsis it really can mean the difference between life and death. Caught early, the outcome is likely to be good. Caught late and it can be bleak. Making sure you and those near you to know the warning signs of sepsis is so important. Times article
Recognising the signs of sepsis
For adults DR Mark Porter says think of the word SEPSIS as a way of providing a checklist to look for:
> S - slurred speach or confusion.
> E - extreme shivering or muscle aches.
> P - passing no urine in a day.
> S - severe breathlessness.
> I. - I feel unwell or worse.
> S - skin mottled or discoloured or a reddish/purplish rash that doesn't blanch with pressure.
If any of these apply seek medical help urgently and make sure you ask "could it be sepsis?"


Sepsis is caused by a combination of infection and the body's immune response to attack which rather than helping to eliminate the invader can sometimes trigger a cascade reaction leading to shock, multiple organ failure and death. Sepsis typically develops after serious bacterial infections such as pneumonia or meningitis, but it can complicate seemingly mundane ones too. Cases have been seen where a cut on the leg or finger from working in the garden have resulted in serious problems and in some cases death.

How common is sepsis
Official figures suggest that there are about 160,000 cases of sepsis every year in the UK leading to about 40,000 deaths. So a death rate of 1 in 4.
Alarmist?
It's worth reflecting on three cases and then decide.

Case 1
Gathering in the leaves in the garden

A fellow mountain walking friend of the V8 Webmaster, a retired physics professor in the US with Scottish ancestry, was clearing up the leaves in his garden and, without wearing gloves, must have pricked his finger on a thorn or holly leaf. He felt slightly unwell that night and like many men thought little of it but later it developed to a stage where the following morning he sought medical advice and was rapidly admitted to hospital. But the rate at which the sepsis developed resulted in his death in two days from his working in his garden. That rapid development of the sepsis illness hit a fit and active man. His widow was left stunned. This is not hearsay but a true story.

It is sound advice to wear good protective gloves when working in your garden.



Case 2
Working on a trellis in the garden

A lady was gardening and at some stage adjusted a trellis when she must have nicked her finger on a nail or timber splinter. That night she was aware she had a sore finger and the following day it became more so. During the second night she awoke and turned on the light to see half of her finger was black. Living on her own she took a photo of her finger on her mobile phone and sent it to her daughter who promptly replied she had ordered an Uber taxi which would arrive in the next 15 minutes to take her mother to hospital. On arrival she was taken straight into the operating theatre for emergency surgery to remove a section of her finger back to a joint. The medics said had she delayed attending A&E for a further couple of hours the surgery could have involved removing the whole arm to save her life. This is not hearsay but a true story.

Case 3
Another sepsis experience and close call

John Watson, a longstanding MGB enthusiast, relates his recent experience with sepsis saying "I have seen an article on the V8 Website regarding SEPIS whilst I am in the process of recovering from it. Here is a brief history of my very sudden illness. On Easter Monday I was finding it difficult to pee, this was hurting by Tuesday and I went to bed early with paracetamol that evening. Wednesday morning I spoke with my doctor who wanted me to go and see her. She checked on a urine sample I had taken in and said I had a urine infection. She sent me home with antibiotics and instructions to take the maximum dose of paracetamol, to go to bed and she would call me in the morning.

At 9.00pm I was shaking so much I could not open my pills, Gill came up and helped me, I then went back to bed. Unknown to me the shaking continued and Gill was getting worried, so she called the emergency 111 service and they dispatched an ambulance, the paramedics tried to put fluid into me which I kept pulling out, my blood pressure was dropping, so I was then transported to the John Radcliffe hospital in Oxford. I came too when we were arriving at the A&E department at around midnight, and there were about 10 doctors and nurses around me and they added more drips etc. I was kept in A&E overnight and transferred to the Intensive Care unit at 06:30 on the Thursday. My blood pressure had dropped and they were worried the infection had got to my kidneys and may be into my heart. As my Doctor told me later you have been very, very, very ill.

I was moved from Intensive Care to a ward on Saturday and left the John Radcliffe on Sunday evening. That was two and a half weeks ago and I am now about 90% OK but get tired if I do too much.

I have been asked to attend a UK Sepsis Trust seminar on Tuesday which could be interesting. I hope my story is of interest, it shows how quickly thing can happen. If Gill had not called 111 at that time it would have been a very bad situation".

Gloves - some practical advice from Nic Houslip

Nic says "I am extremely happy to hear you have recovered. Sepsis is very worrying, especially for us older members, it must relate to reduced immune system efficiency but for the how or why we will have to wait until the medics find out. There was an MP who suffered late in 2016 if I recall.

It might be worth understanding that if you work on your car, the little nicks and scratches that perhaps we ignored years ago [such as a grazed knuckle when the spanner slipped] should be attended to immediately, rather than leaving it until finishing the job.

I have for years shunned the wearing of gloves when working on a car, but my friend who is a Service Manager in a Mercedes dealer gave me a couple of pairs of those nylon mesh woven gloves with a polyurethane coating on the palms and fingers, these are extremely good, and I bought more. Although feel is slightly reduced, this isn’t a problem for most work, but for assembling tiny parts such as are used in carburettors or distributors, fingers are perhaps best, but by then the parts should all be clean.

The gloves are available from PPE suppliers at low cost. I now find that Jackie has been “borrowing” them as they are also good for gardening, and although probably not proof against a rose thorn [not much is], are able to keep hands clean, perhaps helping to prevent infection. Jackie also found out that they are washable, which is useful.

I bought mine from UK Safety Store and Warrior Black PU gloves are the ones I use.