WHAT is responsible for up to 48,000 deaths in the UK each year, has a 20 per cent mortality rate and affects 25,000 children annually?
The answer: Sepsis.
Former delivery driver Dave Cram, 41, knows all too well the devastation it can cause.
He developed it after straining his groin while playing football in January 2020, and ended up at A&E in agony.
Dave, from Blackpool, said: “An emergency doctor saw me coming out of a cubicle, rushed me on to a bed, told my wife I was dying and put me into an induced coma for surgery. I didn’t know I was battling necrotising fasciitis.”
Dave was resuscitated seven times — and on his 40th birthday his family “had to make the painful decision to amputate my entire left leg from the hip.”
Sepsis affects 245,000 people a year in the UK — and 80,000, like Dave, suffer life-changing effects.
Dr Ron Daniels, founder and CEO of the Sepsis Trust (sepsistrust.org) and a consultant in Intensive Care at University Hospitals Birmingham, says: “Research suggests the number of people being diagnosed is going up, but actually we’re just getting better at spotting it.
‘Pain’s 50 out of ten’
“That said, as we become a population that lives longer, and the older generation have more invasive treatments done, and antibiotic resistance increases, we may see more people diagnosed.”
Waking up in pain, Dave first went to his local walk-in centre where he was given painkiller co-codamol and then sent home. But that night he was unable to sleep.
He said: “On a scale of one to ten, with ten being the most painful, it felt like I was a 50.”
SIGNS TO CHECK AT HOME
IN medicine we use various clinical scales to assess someone for sepsis.
There are six main things we look at: Respiratory rate, heart rate, blood pressure, oxygen level, consciousness and temperature. However, at home, you won’t have the kit. Instead, check these signs:
BREATHING: How many breaths are taken in one minute? If it is more than 20 or fewer than nine, this is abnormal.
HEART RATE: How many beats per minute? If it is more than 100 or less than 40, this is abnormal.
CONSCIOUSNESS: Are they alert or are they becoming drowsy or confused? Drowsiness is a cause for concern.
TEMPERATURE: If their temperature is less than 35C or higher than 38.5C, this is concerning.
COOL/CLAMMY PERIPHERIES: Cold hands and feet. This is an extra concerning sign as it means the body is starting to shut down and divert blood to the internal organs. This, in combination with any of the other signs above, requires immediate medical attention.
In A&E for seven hours, he could not pass urine, and felt increasingly bad.
He adds: “Tests showed that my kidneys were failing and my liver was damaged, and in the next two weeks I had seven operations to relieve the pressure of the infection in my leg.
“Eventually I woke up, battered, bruised and with a few broken ribs from the cardiac arrests, but was alive.”
Three months later he was finally discharged from hospital. He says: “I have a prosthetic leg now but I’m by no means recovered. What happened to me will affect the rest of my life.
“Every day I wish I hadn’t accepted the co-codamol and gone home. If I’d said something, maybe things would be different.”
What to do
ALWAYS seek urgent medical advice or go straight to hospital if you think someone may have sepsis.
Not everyone will have typical symptoms. The very old, very young and people who have problems with their immune system can develop unusual features, making diagnosis more difficult.
These people are at the highest risk of developing sepsis, so it is important to be extra vigilant.
Dr Ron adds: “Sepsis is far more common in adults than children. But if you are a parent who suspects sepsis or that your child is unwell, trust your instincts.
“You know your child better than anyone with a medical degree, so be prepared to advocate for them and if you’re not happy, don’t leave your GP surgery or A&E.”
NEED TO KNOW
ON World Sepsis Day, GP Dr Zoe Watson, founder of Wellgood Wellbeing, reveals everything you need to know about sepsis…
WHAT IS SEPSIS? Sometimes called septicaemia or blood poisoning, sepsis is not a disease in itself, but is the body’s reaction to a severe infection already present in it.
For example, you may develop sepsis from pneumonia, an infected insect bite or a viral infection such as the herpes virus. Infections that lead to sepsis most often start in the lung, urinary tract, skin or gastrointestinal tract.
WHY DOES IT HAPPEN? Sepsis occurs when an infection you already have triggers a chain reaction throughout your body, releasing a bunch of inflammatory chemicals to help fight the infection.
This happens in normal infections too, but in sepsis the immune system essentially overreacts and causes too many inflammatory markers to be released.
These chemicals start to interfere with things such as blood clotting and blood pressure, which eventually leads to damage of the body’s internal organs.
If left untreated, sepsis can eventually develop into septic shock – the end stage of sepsis – where the body’s organs have begun to shut down. Without prompt treatment, sepsis can rapidly lead to tissue damage, organ failure and death.
But if caught early and the person is started on the correct treatment (which varies depending on what type of organism is causing the infection which caused the sepsis), they can make a good recovery.
WORRYINGLY, the symptoms of sepsis can often be very vague. It can just feel like a bad flu.
You may have: Lethargy, vomiting, diarrhoea, fever, chills, muscle aches.
All these symptoms are common in many viral illnesses, so it is vital to look for objective evidence of sepsis with a physical examination and a good, clear history laying out the timeline of the illness.
Has there been any evidence of an infection in the days preceding the development of these symptoms? A cut on the hand that looks angry and red?
Increased pain and frequency when peeing, which could suggest a urine infection?
Bad cough and pain on breathing, which could be pneumonia?
An infection that has already been given antibiotics but you still feel very unwell? All of these situations should make your “sepsis radar” ping and for you to seek further medical assessment.