Understanding Sepsis: Early Detection and Management

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Written By NR Medical Training

Sepsis is a serious, life-threatening illness that can develop quickly from an infection. Early diagnosis and treatment is essential for the best possible outcome, so it's important to be aware of the signs and symptoms of sepsis. This article will outline the key warning signs to look out for, and how you can get help if you think you or someone else may be suffering from sepsis. (Sepsis Trust, n.d.)

Understanding Sepsis?

Sepsis (also known as blood poisoning) is an overreaction of the immune system to an infection or injuries. Normally, our immune system fights infection; nevertheless, for unknown reasons, it occasionally attacks our own organs and tissues. Sepsis, if not treated quickly, can lead to organ failure and death. However, if detected early, it is treatable with medication. (Sepsis Trust, n.d.)

The number of people developing sepsis is increasing, with around 123,000 cases each year in England. An estimated 37,000 deaths are associated with the condition (NHS England) - Sepsis Epidemiology UK 2000 to 2012 from a critical care perspective. (Royal College of Nursing, 2021)

Sepsis isn’t currently covered in any first aid courses at work. The closest traditional first aid training gets is with meningitis which is covered on the level 3 paediatric first aid course. We’ve created a bespoke sepsis training course aimed directly at care and support staff entitled Essentials Of Sepsis Recognition & Escalation For Care & Support Staff. This course is co authored and endorsed by the UK Sepsis Trust and falls in line with all current CQC regulations around sepsis training within care organisations.

Signs & Symptoms.

Sepsis may appear to be the flu, gastroenteritis, a chest infection, or a urinary tract infection at first. There is no one symptom, and symptoms present differently in adults and children.

(Sepsis Trust, n.d.)

NEWS 2 Tool For healthcare professionals.

Healthcare professionals use the National Early Warning Score tool in order to calculate both the severity of illness and risk of deterioration in patients. While first aiders are not expected to use this tool I feel that it is useful for everyone to have an overview as to how and why it is used as well as understanding sepsis. It may just help one of your colleagues or a family member one day.

What is the NEWS tool?

NEWS is a tool created by the Royal College of Physicians that enhances the identification and response to clinical deterioration in adult patients. It is an important component of enhancing patient safety and outcomes.

NEWS2, an improved version of NEWS, was released in December 2017.

A number of observations are recorded from a patient and a score is calculated from this. High scores can indicate high risk. Remember that you must always gain valid consent prior to undertaking any physiological measurements.

(The Royal College of Nursing, n.d.)

(Royal College of Physicians, 2017)

What do you need to know in order to calculate a NEWS2 Score?

Respiration Rate (Per minute)

The number of breaths taken per minute is referred to as the respiration rate. When a person is at rest, the rate is normally measured by counting the number of breaths taken in one minute by noting how many times the chest rises. Fever, sickness, and other medical conditions can cause an increase in respiratory rate.

SpO2 % (Oxygen saturation in the blood)

Most first aid kits will not have a pulse oximeter. However, they are small, cheap and readily available from most pharmacies or online. They should come with instructions on how to use them. They normally measure both oxygen saturation in the blood and display this a percentage as well as displaying a pulse rate. It is worth noting that these devices are not always accurate and should be used as a guide. If a patient has very cold fingers, is wearing nail varnish or is moving around a lot the reading may be false. It is also important to note that patients with chronic (long term) lung problems may have a lower oxygen saturation level and that may be normal for them. This why there are two SpO2 scales on the NEWS 2 chart.

Blood pressure (Systolic mmHg)

Not everyone has access to a blood pressure machine. However, they are becoming ever more commonplace in homes. Blood pressure machines measure the pressure of the blood moving away from the heart (Systolic) and also the pressure of the blood returning to the heart (Diastolic). For the purpose of the NEWS 2 tool you’ll need to examine the systolic reading. This is normally displayed as the top number on a blood pressure machine.

Pulse (per minute)

To gain a pulse rate you may be able to use a pulse oximeter as shown above. However you can also get a more accurate reading by feeling for a pulse. The video below explains how to count a pulse by feeling a patients wrist.

Consciousness

First aiders are routinely taught to assess a patients level of response using the AVPU (Alert/Responds only to verbal stimuli/Responds only to pain stimuli/Unresponsive) scale. You’ll notice that there is an extra letter on the NEWS 2 chart. “C” means acute (new) confusion or disorientation.

Temperature (°C)

Many households now sport a temperature monitoring device especially since the onset of Covid 19. One important note is that there are many factors that can affect body temperature. If someone has had Paracetamol or Ibuprofen, these medications can lower core body temperature therefore if a patient has had these medicines recently then the temperature you record may not necessarily be accurate.

What next?

Once you’ve got the physiological observations a score can then be calculated. As mentioned previously this blog is designed to give you an overview of both the signs and symptoms of sepsis and the NEWS 2 tool that healthcare professionals use to calculate the risk of a patient deteriorating.

(Royal College of Physicians, 2017)

Take action!

If you’re worried about an infection you can contact 111 or a GP. In an emergency dial 999 or attend your local Emergency Department. If you suspect Sepsis it’s important to take action immediately.

We now offer a 4 hour Essentials of sepsis recognition for care and support staff course which is a face to face training session designed to help you spot sepsis early.

NR Medical Training
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