What you need to know about sepsis - the condition, life after, and support available
In this guide, our team reviews all the essential information you might need to know whether you have experienced sepsis yourself, or just want to find out more about the condition.
How and when you should “think sepsis”
Sepsis, or septicaemia, is a very serious and frequent condition that arises when the body’s response to infection causes damage to the body itself. It can lead to the body going into shock causing tissue damage, organ failure and, in some extreme circumstances, death.
Symptoms of sepsis can include:
- a fever above 38ºC or below 36ºC
- a rapid heart rate (over 90 BPM)
- a rapid breathing rate (over 20 breaths per minute)
- feeling extremely unwell
- probable or confirmed infection.
In order for a doctor to confirm a diagnosis of sepsis you will usually be showing at least two of these symptoms.
This occurs when the body’s response to sepsis damages one or more of its organs. The symptoms you experience will vary depending on which organ/s is/are affected, but symptoms (on top of the sepsis symptoms above) can include:
- changes in skin colour
- low or no urine output
- disorientation/drowsiness/loss of consciousness
- difficulty breathing
- altered heart rate
- extreme weakness.
This is the most serious version of sepsis, in which there is both organ damage and an extreme drop in blood pressure. In addition to symptoms of sepsis and severe sepsis, septic shock symptoms can include:
- elevated pulse
- dizziness or light-headedness
- lower than normal body temperature
- rapid breathing.
Children’s symptoms can present differently to adults, or the child may not be able to explain what they are feeling.
Telltale signs of sepsis in children include:
- being cold to the touch
- mottled/bluish/very pale skin
- a rash that does not fade when pressed
- fast breathing
- convulsions and lethargy
- or a child under five who is not eating, is vomiting repeatedly and/or has not urinated in 12 hours.
Sepsis is a very particular danger for a pregnant mother or her newborn child. In some instances, an untreated infection in the mother can lead to the development of maternal sepsis. This can lead onto uterine infections and infection of the unborn child.
Very sadly this can go on to cause babies to be delivered in an extremely poor condition and to suffer a brain injury or death. Women can also suffer from complications of infection after delivery of their baby, which is known as postpartum sepsis (most often bacterial sepsis), which can be a life-threatening situation due to multi-organ failure.
Early recognition and treatment of sepsis can save lives. When initial signs are missed, the window of opportunity for early treatment can be lost, and you or your loved one may have been denied the opportunity to make a full or better recovery. If this is the case, we can help you investigate a claim for a delay in diagnosis and treatment of sepsis.
The diagnosis and treatment of sepsis – what you need to know
Some of the common signs and symptoms of sepsis infection include:
- fever to include a high or low temperature
- a raised heart rate
- a raised breathing rate
- a low blood pressure
- a reduction in urine
- altered mental state
What is the correct treatment for suspected sepsis?
When more mild symptoms of infection are present, further tests should be arranged to include blood tests to look for markers of inflammation and clotting abnormalities and a person should be reviewed by a doctor within an hour.
If more severe symptoms of infection are present, sepsis should be suspected, and the ‘sepsis pathway’ implemented immediately.
The sepsis pathway includes:
- administering oxygen to ensure that the amount of oxygen in the blood stays at a healthy level;
- taking blood cultures to try and identify the presence of bacteria in the blood;
- giving intravenous antibiotics within 1 hour;
- giving intravenous fluids within 1 hour;
- testing lactate levels (lactate is produced by the body during periods of oxygen deprivation and trauma); and
- measuring urine output.
If a person is still not improving after delivering the sepsis pathway, then the critical care outreach team should be called immediately.
Life after sepsis – finding the right support
Sepsis can be a long and traumatic condition, and you may feel at a loss as to how to get help once you have been discharged from hospital, especially because residual symptoms are frequently not visible to others. However, there is support out there, and as part of our experience with sepsis claims we understand the range of support available
What you might be experiencing
Some people experience what is known as Post-Sepsis Syndrome (PSS), which is a variable set of physical, psychological and/or emotional symptoms while recovering from sepsis, including but not limited to:
- reduced mobility/muscle weakness
- swollen limbs
- joint/muscle pain
- poor concentration/short term memory loss
These symptoms, or a combination of these, can last anywhere from six to 18 months (or even longer).
You may need to speak to your doctor about PSS symptoms, to try and find ways of managing those symptoms. However, if you bring a claim with us, there are a range of specialists we can help with referrals to in order to help rehabilitate you.
There is not a single approach to dealing with PSS, but professionals we have worked with when clients experience PSS include:
The physiotherapist’s role is to plan and implement a treatment programme with the aim of restoring function and independence.
A tailored plan will be devised around your specific circumstances, including rehabilitation programmes to help you regain muscle function and mobility, reduce joint pain and inflammation, and build stamina.
Occupational therapists are instrumental in helping you return to independent living as far as possible and to support you in doing activities that matter to you. There are a wide range of tasks that an OT can help with by suggesting appropriate aids, equipment and adaptations to help you navigate your life post-sepsis, both at home and at work.
OTs can also help you return to old hobbies or find new ones, as well as give you advice on returning to work if this is proving difficult.
You may be signposted to a variety of mental health services to assist with any psychological symptoms you may be experiencing. These services may include counselling, cognitive behavioural therapy (CBT), helplines, community services or your GP.
These are professionals who are able to help you find strategies to deal with any pain you are experiencing on a day-to-day basis. Depending on the source and level of your pain, treatment can include:
- Transcutaneous Electrical Nerve Stimulation (TENS)
- interventional procedures such as nerve block injections or epidurals
- non-interventional procedures such as physiotherapy
- self-management techniques
If your sepsis treatment has involved limb loss you may be referred to a prosthetist. A prosthetist is a specialist in prosthetics, i.e. the artificial limb/device that replaces a missing body part. Prostheses are intended to restore normal functions of a missing body part as far as possible.
A prosthetist will be crucial to assessing your suitability for using a prosthetic and the specific type/size that may be appropriate. Successful use of a prosthetic often involves many appointments and trials to ensure an optimal fit in order to maximise comfort and function.
Our specialist team can help you to find the right support following a claim for negligent treatment of sepsis, including any of the above. Find out more about making a claim for sepsis right here.
Resources for when you’ve experienced sepsis
The leading sepsis charity in the UK, the trust campaigns for political change, raises public awareness, educates health professionals and provides support for those affected by sepsis.
Tel: 0800 389 6255
Although this is the leading sepsis charity in the US, the Alliance aims to improve awareness and care of sepsis, providing a wide range of resources and information on their website.
The Limbless Association helps amputees with support for their lives beyond limb loss, if you have experienced an amputation as a result of sepsis they may be able to offer support.
If your child has experienced a brain injury as a result of sepsis, CBIT can help you get the support you and your family needs.
The Brain Injury Group offers a range of support for those who have experienced brain injury, including case management.
Meningitis can lead to sepsis, and so Meningitis Now could be a good place to go for support if someone close to you has experienced injury as a result of these conditions.
Group B strep infection can in some cases lead to sepsis also, which in turn may lead to brain injuries in newborns. GBSS have a wealth of experience helping families find the support they need when their lives have been impacted by group B strep.
Unfortunately sometimes sepsis can result in death. If you are looking for support following a bereavement, please take a look at our comprehensive bereavement guide here.
Sepsis: a glossary of related terms
Antibiotics: the principal treatment for sepsis. Ideally treatment should be started within an hour of diagnosis, usually intravenously before being replaced by tablets after 2-4 days. Broad-spectrum antibiotics are usually given initially while the specific bacterium causing the infection is identified.
Bacteremia: when bacteria enters the blood stream, leading to sepsis.
Blood poisoning: another word for bacteremia.
C. diff.: Clostridium difficile (also C. difficile) are bacteria that live harmlessly in the gut for many people, but in combination with some antibiotics they can multiply and produce toxins that cause diarrhoea. It is spread through faecal particles, and can lead to sepsis as the patient’s body tries to fight the infection.
Corticosteroids: helpful in the treatment of some patients with sepsis, although not all. They can help to reduce inflammation and depress the immune system.
CPE: Carbapenemase-Producing Enterobacteriaceae or CPE are, similarly to C. diff., bacteria that mostly live harmlessly in the gut. However, if they enter the blood stream they can cause urine infections, wound infections, pneumonia and septicaemia. They are also spread through faecal particles and are resistant to some antibiotics, as well as making other bacteria more resistant.
Cytokines: proteins released by the body into the blood in response to a bacterial, viral or fungal infection. If they start to attack the immune system they can induce widespread inflammation causing tissue and organ damage (sepsis).
Fatigue: extreme mental and physical tiredness that is not relieved by rest – a common problem when recovering from sepsis that can anywhere from a few weeks to many months.
Group A Streptococcus: a common cause of bacterial infection leading to sepsis. Group A Strep is spread through droplets from the nose or throat.
Group B Streptococcus (GBS): a cause of bacterial infection in newborns, older people and people with certain chronic illnesses such as diabetes. If babies are infected within in the first week of life this is referred to as early-onset GBS disease. If they are infected from 7 days old to 3 months or more this is referred to as late-onset GBS disease.
Women who are 35-37 weeks pregnant are advised to ask their doctor to be tested for GBS so that, if they test positive, they can be treated with antibiotics during labour; if not tested many women will not be aware they are carrying the bacteria.
Hospital-acquired infections: HAI, also called nosocomial infections, these are infections that patients develop in a hospital or healthcare facility. Common HAI include MRSA, C. diff. and CPE.
Intravenous: fluid or medication given through a small catheter placed directly into the vein. The treatment of sepsis may additionally require the use of arterial lines (which go directly into an artery so that blood can be drawn more frequently) and central lines (larger catheters inserted into larger veins, providing fluids more quickly and easily).
IV fluids: you need fluids as well as antibiotics to help prevent the blood pressure from dropping. Usually a combination of crystalloid (containing water soluble minerals) and colloid (thicker fluids such as albumin) fluids are given.
MRSA: Methicillin Resistant Staphylococcus aureus or MRSA bacteria are carried on the skin of patients, and only becomes a problem when the skin is breached by a surgical wound or a device/instrument. The wound can become infected with MRSA leading to systemic infections such as septicaemia. MRSA is resistant to many antibiotics.
Necrosis: tissue cell death. Necrotic tissue is no longer living and is usually black. It is usually removed to prevent further problems.
Nosocomial infection: another term for a hospital-acquired infection or HAI
Post-sepsis syndrome (PSS): a variety of physical, emotional and psychological symptoms experienced by some survivors of sepsis during recovery, usually for between 6 and 18 months.
Sepsis: an overreaction of the immune system to an infection or injury, in which it can attack a person’s own organs and tissues. Can be caused by any type of infection, whether bacterial, viral, fungal or parasitic.
Septicaemia: an alternative name for bacteremia.
Septic shock: if sepsis is left untreated, toxins produced by the bacteria can cause damage to the small blood vessels. This can affect the heart’s ability to pump blood to all areas of the body and lead to dangerously low blood pressure.
Severe sepsis: in addition to signs of sepsis there will be signs of organ dysfunction, usually requiring treatment in intensive care.
Symptoms: there is no set of definitive symptoms, and sepsis can often present similarly to flu, gastroenteritis or a chest infection. Some tell-tale signs include slurred speech or confusion, extreme shivering or muscle pain, urine retention, breathlessness and discoloured or mottled skin.
Vasopressors: medications used to increase blood pressure if sepsis is causing dangerously low blood pressure. Usually given intravenously.