Severe infection, sepsis ED

You have been seen in the Emergency Department and are being treated for a suspected severe infection or sepsis, or because we feel you may be at risk of developing sepsis.

This leaflet describes the signs and symptoms of sepsis and how we treat it.

Sepsis is a rare but serious reaction to an infection. If you develop sepsis you can become severely ill.

Sepsis needs to be treated urgently because it can quickly get worse and lead to septic shock. Septic shock is very serious, as it can cause organ failure and death. You will need to be admitted to hospital for observation, tests, fluids and antibiotics.

There are a number of physical as well as psychological and emotional factors that can affect the recovery time after suffering from sepsis, known as Post Sepsis Syndrome.

Further information is available at

• NHS website, www.nhs.uk/conditions/sepsis/.
• Sepsis Trust, www.sepsistrust.org.

• Sepsis is a rare but serious reaction to an infection. If you get an infection, your body’s immune system responds by trying to fight it. Sepsis is when this immune system response becomes overactive and starts to cause damage to the body itself. This can become life threatening if not recognised and treated quickly.

• Sepsis is a complex syndrome and can be difficult to diagnose and treat. It is a major cause of death, killing approximately 44,000 patients annually in the UK (that is more than bowel cancer, breast cancer and prostate cancer put together).

• It can be hard to tell if you have sepsis. You might not even have a fever or high temperature; you may just feel very unwell. Sepsis can occur following chest or water infections, problems in the abdomen like burst ulcers, or simple skin injuries like cuts and bites.

• Sepsis needs to be treated urgently because it can quickly get worse and lead to septic shock. Septic shock is very serious, as it can cause organ failure and death.

Anyone who has an infection can develop sepsis; however those most at risk include

• Babies younger than 1 year.
• People over 75.
• People who are frail.
• People with diabetes.
• People with weak immune systems.
• People who are having chemotherapy treatment.
• Pregnant women or women who have recently been pregnant.
• People who have recently had surgery.
• People who have recently had a serious illness.
• People with indwelling lines or catheters.

The symptoms are varied but include

• High or low body temperature.
• Fast heartbeat/ breathing.
• Feeling dizzy or faint/loss of consciousness.
• A change in mental state, for example, confusion or disorientation.
• Diarrhoea/nausea and vomiting.
• Slurred speech.
• Severe muscle pain.
• Breathlessness.
• Reduced urine production.
• Cold, clammy, pale or mottled skin.
• A non-blanching rash.

Your healthcare team will

• Examine you to see if they can find where the infection started.
• Take some blood for tests.
• Give you oxygen if you need it.
• Give you extra fluids through a drip if you need them.
• Give you antibiotics.
• If pus has collected anywhere in the body, a surgical operation may be needed to drain it.
• Consider urine tests, x rays or further imaging.
• Monitor your urine output (check how much you wee) as this may include a urinary catheter.

If you develop sepsis you can become severely ill. You will need to be admitted to hospital and may need to be admitted to an intensive care unit for closer monitoring. The length of time you spend in hospital will depend on many factors including how severe the infection is and how unwell you were before coming to hospital.

For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres or your GP.

The NHS website provides online health information and guidance at www.nhs.uk.

NHS 111 phone line offers medical help and advice from trained advisers supported by nurses and paramedics. Available 24 hours a day. Calls are free from landlines and mobile phones.

There are walk-in and urgent treatment services at Brighton Station, in Crawley and at Lewes Victoria Hospital. www.bsuh.nhs.uk/services/ae/.

Patient Advice and Liaison Service (PALS) can be contacted with your comments and concerns, and to provide general support. Email PALS@bsuh.nhs.uk.

RSCH, telephone 01273 664683.

PRH, telephone 01444 448678.

PALS, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE

This information is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

This article is intended for patients receiving care in Brighton & Hove or Haywards Heath.