Healthcare Hub

UKST was founded in 2012 by Dr Ron Daniels, a practicing NHS intensive care consultant in Birmingham, after he witnessed the tragic and preventable death of Jem Abbotts. 

Ron continues to work as one of the charity’s two Joint CEOs, and his clinical inputs are supported by Dr Tim Nutbeam. 

Our clinical and patient-facing resources are also developed in consultation with our team of trained Support Nurses, including Lead Support Nurse Oliver Jones, who has an intensive care background. 

While not a medical professional, UKST Ambassador Melissa Mead knows firsthand the devastating effects of sepsis. She works with healthcare providers and UKST to improve clinical outcomes after the tragic and preventable death of her one year old son, William, to sepsis. 

UKST developed the Sepsis Six in 2005 as a practical tool to help healthcare professionals deliver the basics of care rapidly and reliably. It consists of six actions that should be actioned immediately when sepsis is suspected: 

1. Give the patient oxygen
2. Give intraveneous antibiotics
3. Take blood cultures to identify the source of the underlying infection
4. Give intraveneous fluids
5. Check lactate levels
6. Monitor urine output 

It has been endorsed by NICE and is used in 96% of British hospitals and in 37 other countries worldwide. 

It was drawn from the international guidelines developed by the ‘Surviving Sepsis’ Campaign, but we recognised that a 16 page document containing 58 individual guidelines was unlikely to transform practice. 

In 2011, we published evidence showing it to be associated with a 50% reduction in mortality – findings which others have since replicated.

Red Flag Sepsis was developed by the UK Sepsis Trust in 2015. It is a practical, operational tool that empowers frontline health professionals to act without the need to apply the complex formal international definition of sepsis.

Based on the National Early Warning Score (NEWS), together with other parameters known to represent high risk in patients with sepsis, Red Flag Sepsis has since been supported by The National Institute for Health and Care Excellence (NICE).

We recommend that any patient who looks unwell, or who is triggering on the NEWS-2 score (Royal College of Physicians 2018), is screened for sepsis. If there is clinical suspicion of infection, then the presence of one or more Red Flags should be evaluated. If a Red Flag is identified, the Sepsis Six pathway should be started immediately.

Yes, the downloadable PDF toolkits allow you to make small amends such as adding your trust’s logo. 

If you wish to discuss further modifications, please get in touch via email: info@sepsistrust.org 

Around 40% of people who develop sepsis are estimated to suffer physical, cognitive, and/or psychological after effects.

For most people, these effects will only last a few weeks, but others can face a long road to recovery and develop Post Sepsis Syndrome (PSS). Post Sepsis Syndrome (PSS) describes a variable set of ongoing issues that people encounter for a prolonged period of time following sepsis.

PSS management by healthcare professionals typically involves addressing the specific symptoms experienced by the individual, and may include physical rehabilitation, cognitive rehabilitation, psychological counselling, and supportive care to help improve the patient’s overall wellbeing.

Learn more

With multiple agencies, including the World Health Organisation, recognising that the rapid identification and management of sepsis is a public health priority, every healthcare provider organisation should have a policy and/or pathway on sepsis.

If yours doesn’t have one, or uses an outdated version, why not lead its implementation or development? Identify the right people to speak to – typically safety or governance leads, or clinical champions.Organise a meeting, download the relevant tool for your clinical area from our tools page, and off you go. If you come up against barriers, get in touch. We might be able to help.

There are three good things about the sepsis-3 definition:

• The narrative: that sepsis is a life-threatening condition arising when the body’s dysregulated response to infection causes organ dysfunction. This has removed the old ambiguity about describing patients with some systemic signs, but who were relatively well, as having ‘sepsis’.
• The new ‘official’ definition of organ dysfunction, using a change in SOFA (Sepsis-associated Organ Failure Assessment Score).
• Dropping SIRS (the Systemic Inflammatory Response Syndrome) from the definition of sepsis – SIRS was over-sensitive and poorly specific.

So yes, use the narrative* and let’s not use SIRS to diagnose sepsis!

If you’re a researcher, a change in SOFA score is the most appropriate way to ensure you’re recruiting the right patients. But at the bedside, we need something simpler – we use Red Flag sepsis as an empowering surrogate.

There is nothing wrong with qSOFA, the ‘bedside’ test proposed by the International Consensus Definitions Task Force. It is based on some evidence, albeit via a retrospective analysis of a large dataset, but is not prospectively validated.

It’s important to note that the Task Force did NOT propose qSOFA as either a treatment prompt or as a diagnostic tool – it was an identifier of patients in whom to look for sepsis.

Because we already use NEWS in the UK, and because it has since been shown to be as useful as qSOFA, we feel we should stick with what we know. We didn’t want our healthcare assistants, nurses, midwives and doctors to be asked to measure general risk using one scoring system, and then sepsis risk with another using different thresholds! 

If your organisation uses electronic observations, it’s perfectly appropriate for qSOFA to be added as a second tool to identify risk. If you can’t automate it, though, both we and NICE suggest you stick with NEWS.

Sepsis is treated with antibiotics. But antibiotic resistance is a growing threat. UKST is an advocate for responsible antimicrobial stewardship, ensuring appropriate use of antibiotics are built into all its activities relating to sepsis training, diagnosis and treatment.