Resources to support the understanding and treatment of sepsis.
Sepsis is a potentially life threatening condition that is triggered by an infection. The body's immune system goes into overdriven setting of a series of reactions, including inflammation and blood clotting. This can lead to a significant decrease in blood pressure, which can mean that blood supply to vital organs is reduced (1). In lay terms, the body's response to infection injures its own tissue and organs (2).
Symptoms of sepsis may include fever or chills, elevated heart rate, and rapid breathing (1,3,4). Other symptoms can include severe muscle pain, slurred speech, pale or mottled skin, and confusion or disorientation (4,5).
Definitions around sepsis are evolving (6), however, the following have currently acheived consensus (2,7,8):
"Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection." (2).
"Sepsis shock is a subset of sepsis in which circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality." (2)
In the UK, it is currently estimated that there are 150,000 cases of sepsis every year, and over 40,000 of these are severe cases (9).
This short introduction by Professor Kevin Rooney provides an overview of Sepsis and the use of the Sepsis App to help recognise the signs and promptly take action to reduce mortality in Acute Care.The app is a collaboration between NES and the Scottish Patient Safety Programe (SPSP).
- A National Early Warning Scoring System (NEWS) calculator to alert clinicians to the deteriorating patient and acute illness.
- A Sepsis screening tool for the prompt recognition and the timely initiation of treatment.
- An outline of the 'Sepsis 6' care bundle.
NEWS supports a standardised method for assessment of a person’s physiological parameters. NEWS has been shown to provide improved prediction of poor outcomes such as unplanned admission to critical care and cardiac arrest and supports earlier recognition of people with Sepsis.
The aim of this resource is to support health care staff to develop and maintain competency in the use of NEWS.
- The purpose of NEWS
- The physiological parameters included in NEWS
- The process for performing NEWS
- The NEWS thresholds and triggers
- The role of NEWS in screening for sepsis
- The correct response for a deteriorating patient (including sepsis)
- The correct use of NEWS in treatment escalation planning
- How NEWS may link to consideration of an Anticipatory Care Plan.
NHS Education for Scotland educational resources
This document brings together some of our NHS Education for Scotland (NES) sepsis educational resources (last updated September 2016). Note: given the changes to the definition of sepsis, some of these resources may refer to previous, alternative terms, which are now not formally recognised. The management and need for urgent treatment remain unchanged, and resources will be updated, as appropriate.
- Sepsis educational resources - 2017 ( Download, 339 KB)
Finally, a range of other resources which are aimed at preventing, reducing and managing infection are also presented:
1. NHS Choices, (2016). Sepsis. Available from: http://www.nhs.uk/Conditions/Blood-poisoning/Pages/Introduction.aspx [Accessed 01 December August 2016].
2. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al., (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8):801–10. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.0287 [Accessed 26 August 2016].
3. McClelland H, Moxon A., (2014). Early identification and treatment of sepsis. Nursing Times, 110(4):14–7. Available from: http://www.nursingtimes.net/nursing-practice/specialisms/infection-control/early-identification-and-treatment-of-sepsis/5067163.article
4. National Institute for Health and Clinical Excellence, (2016). Sepsis: recognition, diagnosis and early management: NICE guideline. Available from: https://www.nice.org.uk/guidance/NG51 [Accessed 13 July 2016].
5. NHS Choices, (2015). Septic shock. Available from: http://www.nhs.uk/conditions/septic-shock/Pages/Introduction.aspx [Accessed 26 August 2016].
6. Abraham E. (2016). New definitions for sepsis and septic shock: Continuing evolution but with much still to be done. JAMA, 315(8):757–9.
7. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al., (2016). Consensus Definitions for Sepsis and Septic Shock (video). Available from: http://jama.jamanetwork.com/multimediaPlayer.aspx?mediaid=12511362 [Accessed 26 August 2016].
8. JAMA Network, (2016). Consensus Definitions for Sepsis and Septic Shock. Available from: http://sites.jamanetwork.com/sepsis/ [Accessed 26 August 2016].
9. NICE, (2016). Sepsis is just as urgent as heart attack, says NICE . Available from: https://www.nice.org.uk/news/article/sepsis-is-just-as-urgent-as-heart-attack-says-nice[Accessed 26 August 2016].
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McCelland, H. & Moxon, A. Early identification and treatment of sepsis . Nursing Times, 2014. 110(4): 14-17.
Fitzpatrick, D. McKenna, M. Rooney, K. Beckett, D. Pringle, N. Improving the management and care of people with sepsis . Emergency Nurse, 2014. 22(1): 18-24.