Sometimes the human body may respond to infections or injuries in an unusual manner. Sepsis is one such condition. It is a deadly disease and can become life threatening if timely treatment is not provided. While infections in the kidney, pneumonia or a persisting pain during urination are specific signs of this condition, the typical symptoms are:
• Increased heart rate (more than 90 beats per minute)
• Rise in the core body temperature or fever (less than 96.8° F or more than 101° F)
• Confusion or disorientation
• Increased breathing rate (more than 20 breaths per minute)
In some cases, sepsis can manifest as severe sepsis (inadequate blood flow) and Septic shock (abnormally low blood pressure).
The infections in this condition may be fungal, bacterial, viral or even parasitic. Usually, the sites that get infected are abdominal organs (stomach, liver, pancreas and intestines among others), urinary tract, lungs, skin and the brain.
Mostly the victims are the elderly, the newborn and individuals with a weak immune system.
There are different types of sepsis treatment depending on the area infected, the reason for initial infection, the affected organs and severity of any damage. If you exhibit early signs of sepsis, you will have to go to the hospital for diagnosis and treatment. Septic shock and sepsis which is serious require a medical emergency.
You will require three tests (termed as “sepsis Six”) and three treatments for sepsis when you are in the hospital. The old screening test SIRS has been replaced by qSOFA (Sequential Organ Failure Assessment Score). Two out of the following three signs are considered as triggers.
• Low blood pressure
• Increased breathing rate
• Altered state of consciousness
The medical team should initiate this within one hour of diagnosis.
Sepsis Treatment While Hospitalized
• Antibiotics- If there has been an early sepsis diagnosis, the patient can continue taking the tablets at home as the infection may reoccur.
• Intravenous fluids - They are given according to the BP, urine output and heart rate.
• To increase ventilation, the head portion of the bed is raised and oxygen is provided in case if it is low.
Tests for sepsis will include:
• Sampling blood cultures to know the kind of bacteria or other agents causing sepsis.
• Blood samples to assess how serious the sepsis is.
• Checking the urine output to know the severity and how the kidney is functioning.
• Additional tests like mucus secretion (for germ identification) and wound secretion (to identify an open sore/wound) are done to be sure of the condition.
When is Emergency Treatment Required?
A sepsis patient will require emergency treatment in the hospital and may also be admitted to the ICU (intensive care unit) if:
• The sepsis is far-reaching and the vitals are not consistent.
• The patient develops a septic shock which occurs when the blood pressure drops very low.
Affected functions of the body like blood circulation or breathing are supported by the ICU while the doctors treat the infection.
Since vital organs are affected, individuals suffering from severe sepsis will more likely become very sick and four in every ten patients die. Six in every ten patients with septic shock will die probably since it is very severe. However, sepsis can be treated if quick treatment is provided with early diagnosis and many of the times full recovery is achieved with no long-term complications.
Treatment with Antibiotics
Antibiotics are the main treatment for sepsis whether it is severe or septic shock. They are administered intravenously (directly into a vein) if you suffer from severe sepsis or septic shock. To minimize the chances of developing serious problems or death, antibiotics should be given within one hour of diagnosis.
Antibiotic tablets replace intravenous antibiotics after 2-4 days. You may take antibiotics for 7-10 days depending on how serious your condition is,.
Types of Antibiotics
Broad-spectrum antibiotics are given first before the type of infection is diagnosed.
The antibiotic for specific infection is then given after the particular bacterium is diagnosed.
Treatment for Viral Infections
Antibiotics are not effective when a virus is the cause of the sepsis. However, you will receive antibiotics first before diagnosis since delayed treatment can be very dangerous. Although some patients are given antiviral medicines, a viral infection normally clears on its own.
Importance of Intravenous Fluids
Sepsis patients require plenty of fluids to avoid kidney failure and dehydration. If you have septic shock or severe sepsis, fluids will be given intravenously within the first 24 to 48 hours once you have been admitted.
To identify kidney failure, doctors will need to monitor the urine output. To do this, a catheter is inserted into the bladder for patients with septic shock or severe sepsis.
Importance of Oxygen
If you have sepsis, your oxygen demand will be high. Oxygen will be provided if oxygen levels are low. It can either be through tubes inserted through the nose or a mask.
Treatment of the Source of Infection
The primary cause of the disease such as a wound that is infected or abscess has to be treated upon identifying. Any pus present may require draining, or if the case is severe, surgery has to be performed in order to remove tissues that are affected or to repair any damage.
If the primary cause has not been identified then the doctor may conduct X-rays, ultrasound and a MRI to diagnose the infection.
Vasopressors are given to sepsis patients with low blood pressure. They are administered intravenously while the patient is in the ICU. To increase blood pressure, more fluids may also be administered intravenously. The recommended drugs are Norepinephrine, which if not enough can be coupled with either Vasopressin or Epinephrine.
Other Sepsis Treatments
Additional treatment may be required such as:
• Insulin medication or corticosteroids
• Dialysis (filtering of blood by a machine to imitate the kidneys)
• Mechanical ventilation (use of a machine to aid breathing)
These are commonly done while the patient is in the ICU.