September is Sepsis Awareness Month
Grand River Health Community Relations Specialist
Every year more than one million Americans develop sepsis—a life-threatening medical condition that arises when the body initiates a powerful immune response against an infection.
Anyone can get sepsis, but two-thirds of all cases occur in people over the age of 65. According to the Cleveland Clinic, around 40 percent of patients who get sepsis don’t survive—making it the 10th leading cause of death in the United States.
Researchers believe that as we age, our immune system becomes less effective at fighting infections. This results in older people contracting more infections that are more severe. Every infection we get means we have a risk of developing sepsis.
As people age, they may develop chronic illnesses, such as diabetes, kidney disease, or heart failure. It’s not unusual to see someone with two or more chronic diseases. According to the Mayo Clinic, research has shown that these diseases, along with cancer, chronic obstructive pulmonary disease (COPD), hypertension (high blood pressure), liver cirrhosis, and HIV are common conditions among people who have sepsis.
Because their immune systems are not completely developed, young babies may get sepsis if they become infected and are not treated in a timely manner. Often, if they develop signs of an infection such as fever, infants must receive antibiotics and be admitted to the hospital. Sepsis in the very young is often more difficult to diagnose because the typical signs of sepsis (fever, change in behavior) may not be present or may be more difficult to ascertain. Hospitalized patients are at risk to develop sepsis from infections due to intravenous lines, catheters, surgical wounds, and/or bedsores as well as people with weaker immune systems, such as those with HIV or those in chemotherapy treatment for cancer, people being treated in an intensive care unit (ICU) and people exposed to invasive devices, such as intravenous catheters or breathing tubes.
Any type of infection can cause sepsis, from the flu to an infected bug bite, but the most common infections that trigger sepsis among older people are respiratory, (pneumonia) or genitourinary, (urinary tract infection or UTI). Infections can also happen through infected teeth or skin sores, either from a simple skin tear because the skin may be dry or fragile, or a pressure sore from sitting in a wheelchair or lying in bed. There are many ways an infection can take hold.
It’s not always easy to spot infections among older people. For example, symptoms of a UTI usually include the need to urinate frequently, a sense of urgency (needing to urinate immediately), not feeling as if you’ve emptied your bladder completely, burning or pain while urinating, and cloudy and foul smelling urine. For many seniors though, the first sign of a UTI is a change in their mental status – they become confused or disoriented. So the infection could be present for quite a while before it is noticed. The same could happen with other infections, like pneumonia.
Since infections might not be obvious, if an older person becomes confused or behaves in an unusual manner, or if confusion or disorientation worsens, this could be a sign of an infection.
Signs of sepsis are generally the same, however, among all adults:
• Change in body temperature, either a fever (above 101.3 degrees F) or a lower than normal temperature (below 95 degrees F);
• Rapid heart rate (above 90 beats per minute);
• Rapid breathing (above 20 breaths per minute);
• Confusion, which may be more common among older people
The key to fighting this dangerous condition is recognizing it early and treating it quickly.
Treatment is with IV fluids and antibiotics. Other medications, such as those to raise blood pressure may be needed. If someone you know is admitted to an intensive care unit (ICU), you may see many machines used to monitor various things, such as body function (heart rate, blood pressure), medications and IV fluids that are being administered, and perhaps a ventilator to help the patient breathe.
The key to preventing sepsis is to prevent an infection from occurring in the first place. If an infection does set in, it must be treated as quickly and effectively as possible.
Many illnesses can be, and are prevented through regular vaccinations, such as the flu or pneumonia.
The risk of getting an infection also drops with proper hand washing. Thorough, proper and frequent hand washing with either soap and water or soap-less products decrease the number of pathogens that could enter your body.
Infections can also be reduced by proper care of all wounds, even the smallest scrape or cut. A thorough cleaning with soap and water will help remove any bacteria at the wound opening.
Be aware of symptoms and worsening conditions. Any infection should be taken seriously and action must be taken.
Sources: Mayo Clinic, Cleveland Clinic, EMedicine Health and Sepsis.org