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September: Sepsis Awareness month

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Sepsis, also known as blood poisoning, is a serious and life threatening condition which acts rapidly, and kills 44,000 people in the UK each year. In the USA, more than one person loses their life to sepsis every 2 minutes. It is known as a ‘hidden killer’, due to the speed at which it can shut down the body, and so September is dedicated as Sepsis Awareness month. Knowing the signs and symptoms to look out for might just save a life.

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The NHS advise that urgent medical advice is required if there are changes in:

Temperature

  • temperature over 38C in babies under three months
  • temperature over 39C in babies aged three to six months
  • any high temperature in a child who cannot be encouraged to show interest in anything
  • low temperature (below 36C – check three times in a 10-minute period)
  • chills or shivering

Breathing

  • finding it much harder to breathe than normal – looks like hard work
  • making “grunting” noises with every breath
  • can’t say more than a few words at once (for older children who normally talk)
  • breathing that obviously “pauses”
  • breathing quickens suddenly

Toilet/nappies

  • not had a wee or wet nappy for 12 hours

Eating and drinking

  • new baby under one month old with no interest in feeding
  • not drinking for more than eight hours (when awake)
  • bile-stained (green), bloody or black vomit/sick

Activity and body

  • soft spot on a baby’s head is bulging
  • eyes look “sunken”
  • child cannot be encouraged to show interest in anything
  • baby is floppy
  • weak, “whining” or continuous crying in a younger child
  • older child/adult who’s confused
  • not responding or very irritable
  • stiff neck, especially when trying to look up and down

Sepsis can quickly spiral into septic shock, when blood pressure plummets.

Symptoms of this can include:

  • feeling dizzy or faint
  • a change in mental state – such as confusion or disorientation
  • diarrhoea
  • nausea and vomiting
  • slurred speech
  • severe muscle pain
  • severe breathlessness
  • less urine production than normal – for example, not urinating for a day
  • cold, clammy and pale or mottled skin
  • loss of consciousness

UST609_Sepsis_New_Adult_BusCard_CR3-1_Page_1Seek urgent medical advice if you suspect sepsis – NHS 111 will be able to direct you to the appropriate help. Severe sepsis and sepsis shock are incredibly serious: go straight to A&E or call 999. If in doubt, seek advice. Sepsis can act quickly, and can take over the body without much warning – the faster you act, the better the outcome.

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I have been privileged to speak to 2 strong mamas who have encountered sepsis. The first, Aimee, told me about the time her son, Clark, was taken seriously ill:

‘Clark was exactly 12 weeks old. It was a Friday evening and he had not been ‘well’ all week. I had taken him to our GP on 3 occasions that week explaining that he was ‘chesty’ and had a temperature. Each time there was a further concern – not feeding and then being very sleepy. I was told that he had a virus and that I was maybe being a little fussy due to him being a ‘small premature baby’.

However on that Friday evening, he was struggling to catch his breath and I called 111. I was advised that due to his age they would send a paramedic by ambulance to check him over. We were taken to hospital ‘to be on the safe side’, however they were ‘not overly concerned’. We were sat in the Children’s A&E and a nurse walked past and asked how long he had had the rash on his skin (mottled appearance) I explained for around 24 hours.

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We were taken in a side room and bloods taken from his heal. Within 30 minutes a nurse calmly walked in and said we needed to move rooms. As I wandered down the short corridor I noted we were walking into Resus. A team of professionals quickly rushed in and immediately started to hook Clark up to various machines and try to fit a baby cannula. I was told his body was shutting down and that action needed to be taken. This would involve a doctor using a drill to penetrate the bone in his leg, which would enable them to ‘push much needed fluids’ into him through the bone. The machines were all going off and Clark was simply lying on the bed not responding to the chaos around him. The drill was the most awful thing I have experienced, however: it most definitely helped to save his life.

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Once he was in a more stable condition, a consultant came to speak to me explaining, that they were treating him for sepsis and that the blood gases in his body were abnormal. They were concerned that, due to how poorly he appeared, he may also have a form of meningitis.

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I was advised that we would be transferred to a high dependency hospital by ambulance where we would stay for 2 weeks. He would need IV antibiotics and fluids, then a nasal gastric tube fitted to start feeds when needed. The next 8 days involved me and my boy in a side room of a hospital ward, with him simply sleeping and having various people come to assess, monitor and ‘medicate’ him.

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Thankfully, baby Clark made a full recovery

Remarkably, after just eight days he was completely back to his normal self. On discharge, I was told by a doctor that, in their opinion, if I had left him until the morning after we were taken in, that he more than likely would have passed away in his sleep. The team who cared for him that evening most definitely saved his life, and I will always be grateful to that nurse who observed, cared acted upon her instinct.’

Rebecca kindly told me her story, too, where she contracted sepsis only days after the birth of her first child:

‘I contracted sepsis after giving birth to my son via c-section 11 years ago and it almost killed me. An uncontrolled infection took over my body when I was 8 days postnatal. I’m very lucky to be alive to tell the tale but not everyone survives: Sepsis is the leading cause of maternal death in the UK. Sepsis is essentially blood poisoning- you may have heard of the old term ‘septicaemia’- as the body over-reacts to an infection and begins attacking itself. There are several key symptoms which emerge, in no particular order, but the most striking thing to be aware of with sepsis is the speed with which it takes hold.

My symptoms were:

  • Very high temperature (40+)
  • Shivery and achey, flu-like
  • Rapid breathing (more than twice a second at some points)
  • Racing heart, fast pulse
  • Vomiting and diarrhoea (trying to vomit in the sink while on the toilet, simultaneously breastfeeding an 8 day old is no mean feat!)
  • Barely peed all day (this is a real warning sign for both adults and children)
  • Hallucinating and/or delirious
  • I really felt like I “was dying” in a way that I can’t really explain and apparently I “looked ill”.

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We knew something was wrong, but as first time parents, we didn’t know what was to be expected after childbirth and what wasn’t. A GP and a midwife saw me and diagnosed an infection but didn’t take full account of all my symptoms. Thankfully, when I totally lost control over my bodily functions, my husband’s instinct to get help immediately was right. The out-of-hours doctor who came in the early hours took one look at me and called an ambulance. By this point, I had very low blood pressure (60/20!), I had developed an all-over sunburn-like rash and then my arm/hand/fingers started tingling. This is when my body started shutting down.

The body is very clever and it redirects blood supply (and therefore oxygen) towards the vital organs, away from the extremities. This is why I felt tingling; the limb was beginning to ‘die’. Once diagnosed, treatment for sepsis is actually very simple: IV antibiotics and, very often, IV fluid and oxygen. I had a more aggressive treatment plan including morphine, noradrenaline, surgery and ventilation (“life support”), as my body had gone in to septic shock.

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I spent a week in ITU/HDU and then a further week in a side room on the postnatal ward, which was pure torture for a new, first time mum without her baby. I lost 3 stone in two weeks while in hospital and went home with a deep open wound (which looked like a shark bite!), which I had for six months before having a further operation. (Another week of not being able to care for my baby!)

In those six months, I had repeated antibiotics as the wound continued to get re-infected, and months of physiotherapy. I also lost lots of my hair and the skin peeled off my hands and feet! My physical recovery was slow and painful but I suffered with the emotional and mental after effects for years. Those precious early weeks away from my newborn baby boy were perhaps the hardest part of it all and, as strange as it might sound, it’s taken me a long time to forgive myself and get over it. I don’t cry on my sepsis ‘anniversary’ anymore and I am capable of talking about it openly.

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I was very lucky to fall pregnant again – which we were told might not be the case – and I now have three beautiful children. I was closely monitored in pregnancy and postnatally and their deliveries were by planned caesarean due to my damaged uterus and masses of scar tissue. My youngest bundle of joy is my last, as it’s no longer safe for me to carry and deliver another baby. I have some minor, long-lasting effects from sepsis but I’m here!

The UK Sepsis Trust was founded in 2012, six years after I contracted it, and their work in raising awareness is proving to be vital in saving lives. However, more work needs to be done. Trust your instincts. Just Ask: Could it be Sepsis?’

There is a fantastic charity ‘The UK Sepsis Trust’, which is an excellent resource to help spread awareness. The UK Sepsis Trust also helps to set up fund raising events, to raise awareness and as well as vital funds to help conduct valuable research into this deadly condition. You can donate to the charity here.

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Thank you so much to Aimee and Rebecca for sharing their harrowing stories.

Save a life: spread awareness. Please share and pass on this information during Sepsis Awareness month.

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Love,
Squidmamma x

Information cited from The NHS advice website and The UK Sepsis Trust.

 

 

 

 

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