Consider T.I.M.E. when dealing with sepsis

Nearly 270,000 people in the U.S. die annually as a result of sepsis — more than the number of people who die from prostate cancer, breast cancer and AIDS combined. Yet more than 40% of adults are unfamiliar with the danger of sepsis.

What is sepsis?

Sepsis occurs as a result of an infection and can quickly become life-threatening. When your body has an infection, the natural response is for the immune system to fight the infection. If the body creates an overwhelming response to the infection, inflammation can develop, triggering sepsis.

Any type of infection that occurs anywhere in the body can lead to sepsis.

Infections most commonly occur in these parts of the body:

• Bladder
• Lungs
• Skin
• Soft tissues of fat or muscles
• Urinary tract

Who is at risk of developing sepsis?

There is a myth about sepsis that only people who have been hospitalized are at risk of developing sepsis. In fact, 87% of cases originate outside of the hospital setting. Another myth is that sepsis is rare and only affects people with pre-existing conditions.

Anyone can develop sepsis, but these people are at a higher risk:

• Adults 65 or older
• People with weakened immune systems
• People with chronic medical conditions, such as diabetes, lung disease, cancer and kidney disease
• People who have had a recent hospitalization
• People who have had sepsis previously
• Children under 1

What are symptoms of sepsis?

The acronym T.I.M.E. is a helpful tool for recognizing and remembering the signs and symptoms of sepsis:

• T: temperature — higher or lower than normal
• I: Infection — signs and symptoms of an infection
• M: Mental decline — sleepy, difficult to rouse, confused
• E: Extremely Ill — severe pain, discomfort, shortness of breath

Suspected sepsis should be handled as an emergency by calling 911 and going to a hospital, similar to a heart attack or stroke. Urgent response and rapid, aggressive treatment increase the rate of survival.

Diagnosing sepsis

Sepsis can be difficult to diagnose with a need to pinpoint the source of infection. Symptoms of early sepsis can appear similar to other conditions. Blood and urine tests and imaging scans may be used to help identify the type and location of infection.

People at risk of sepsis or who have had sepsis previously should be proactive in talking with their provider and care team about the possibility of sepsis.

Sepsis treatment

Treating sepsis as early as possible is important to prevent it from worsening. Determining where the infection is and eliminating it is vital to keep sepsis from progressing to severe sepsis or septic shock. Even with treatment, sepsis can progress to severe sepsis or septic shock causing organ damage.

Close monitoring and treatment for sepsis takes place in the hospital setting, typically with a combination of:

• Intravenous fluids
• Antibiotics
• Other medications — may include vasopressors, corticosteroids, pain relievers
• Supportive therapy, such as oxygen, ventilator, dialysis
• Surgery — may be needed to drain or remove infection

Many people who recover from sepsis return to the same level of activity they had before their bout with sepsis. Some people, especially those with weakened immune systems or chronic illness, may experience long-term side effects.

Reducing sepsis risk

Talk with your primary care provider if you are at increased risk of developing sepsis. Take these steps to reduce your risk:

• Prevent infections. If you have chronic conditions, follow your health care provider’s directions to manage the conditions. Get recommended vaccines based on age.
• Practice good hygiene. Wash your hands regularly with soap and water or an alcohol-based hand sanitizer. Clean and cover cuts until healed completely.
• Know the signs and symptoms. Temperature, infection, mental decline and extremely ill feeling (T.I.M.E.) are reasons to suspect sepsis and get help fast.

Joseph Poterucha, D.O., specializes in intensive care and pediatric and adolescent medicine in La Crosse, Wisconsin.