JUST ASK
COULD
IT BE
SEPSIS?

IT’S A SIMPLE QUESTION,
BUT IT COULD SAVE LIVES.

SEPSIS is a potentially life-threatening condition, triggered by infection.

It’s hard to spot, but it kills at least 44,000 people a year in the UK.

It can be easy to treat if caught early. We urgently need the healthcare community to help us spot SEPSIS more quickly.

WHAT IS SEPSIS?

SEPSIS is when the body’s response to infection injures its own tissues and organs.

Sepsis is a life-threatening condition arising when the body' abnormal, or 'dysregulated', immune response to an infection causes organs to begin to fail.

Sepsis can be triggered by any infection, but most commonly occurs in response to bacterial infections of the lungs, urinary tract, abdominal organs or skin and soft tissues.

Caught early, outcomes are excellent. Left unchecked, the patient is likely to spiral to multi-organ failure, septic shock and death.

44,000

People lose their lives to SEPSIS every year.

£2 billion

Is the estimated amount that SEPSIS costs the NHS annually.

HOW CAN HEALTHCARE
PROFESSIONALS HELP?

Teamwork.

SEPSIS is everyone’s problem. Few, if any, conditions have such an ability to affect any patient presenting to any facet of healthcare.

Spotting SEPSIS requires vigilance, robust systems such as NEWS, and excellent pathways of communication and response. If we’re to save lives, everyone needs to know their role.

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Education Resources

SEPSIS RED FLAGS

  • Responds only to voice or pain / unresponsive
  • Acute confusional state
  • Systolic B.P ≤ 90 mmHg (or drop > 40 from normal)
  • Heart rate > 130 per minute
  • Respiratory rate ≥ 25 per minute
  • Needs oxygen to keep SpO2 ≥ 92%
  • Non-blanching rash, mottled / ashen / cyanotic
  • Not passed urine in last 18 h / UO <0.5 ml / kg / hr
  • Lactate ≥ 2 mmol / l
  • Recent chemotherapy

IDENTIFYING SEPSIS

SEPSIS is a serious condition that can initially look like flu, gastroenteritis or a chest infection.

Think sepsis if the patient:

  • Is triggering an early warning score
  • Looks ill (to a health professional or an unusually concerned relative)
  • Has any signs of infection

The National Early Warning Score (NEWS) has been shown to identify patients at risk of deterioration. In the context of infection, a NEWS >5 should always prompt a screen for SEPSIS, including an immediate check for any Red Flags.

It’s vital we listen to patients and their relatives. If a relative says ‘he’s never been this unwell before’, he hasn’t.

If left untreated, SEPSIS can lead to shock, multi-organ failure and death.

THE SEPSIS SIX

The SEPSIS Six was developed by founders of the UK Sepsis Trust in 2005 as an operational solution to a set of complex yet robust guidelines developed by the International Surviving SEPSIS Campaign. It has since spread to use in more than 30 countries.

1.

GIVE 02 TO KEEP SATS ABOVE 94%

2.

TAKE BLOOD CULTURES

3.

GIVE IV ANTIBIOTICS

4.

GIVE A FLUID CHALLENGE

5.

MEASURE LACTATE

6.

MEASURE URINE OUTPUT

GUIDELINES, DEFINITIONS & PRACTICAL SOLUTIONS

The last 5 years have seen significant changes to the international definitions of SEPSIS, and to our understanding of what works (and what doesn’t) in managing the condition. Though definitions and guidelines will continue to change as our scientific knowledge improves, with the launch of the NICE Guideline NG51 (supported by UKST) in 2016 we can look forward to a period of clarity and stability.

NICE broadly supported the use of UKST’s operational solution to an ‘official’ definition which uses ‘Red Flags’, based upon observations we already take at the bedside, to trigger an intervention.

To manage SEPSIS, it has become increasingly clear that a rapid response, managing the patient using the basics of care and escalating when the patient doesn’t respond, is more effective than any complex pathway- the SEPSIS Six is here to stay!

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