Let’s change the trajectory of sepsis

The story is all too common – an individual feels sick and after just a few days goes to their primary care doctor or urgent care center. They are assessed, sent home, and just a few days later they’re returned to the office and reassessed. This cycle continues until the person’s health eventually deteriorates to a critical point and the person leads to the emergency department (ED). Upon arrival on the emergency department, it seems they’ve sepsis and are admitted. In many cases, they arrive with severe hypotension and are admitted to the intensive care unit with septic shock.

What went fallacious? Sepsis just isn’t diagnosed.

In 2011, the Sepsis Alliance designated September as Sepsis Awareness Month (Sepsis Alliance, 2023). According to the Centers for Disease Control and Prevention (CDC), 1.7 million Americans develop sepsis every year, and 350,000 of them die or are discharged to hospice. Sepsis is a worldwide problem; Each yr, 11 million people die from sepsis worldwide, 65% of whom are between the ages of 65 and 79 and 89% are over the age of 80 (CDC). A recent study published on medico-legal sepsis claims in Canada found that amongst admitted patients with sepsis, 49% of patients had multiple visits to primary care providers, outpatient clinics, or the ED within the 72 hours prior to admission (Neilson et al., 2023) .

Lack of awareness about sepsis is a multifactorial problem.

According to the literature, underdiagnosis of sepsis might be divided into three categories depending on provider, team and system aspects.

1. Factors include lack of expertise about sepsis, inappropriate treatment and patient monitoring.
2. Factors include a scarcity of communication throughout the care team, which delays contact with the patient and family.
3. aspects are likely to focus on access to care and resources, delays in admissions and transfers.

Regardless, lack of time to properly assess and follow up with patients, lack of expertise about sepsis, and lack of access to care resources are consistently evident. These problems aren’t unique to sepsis; are an ongoing problem in a sick healthcare system.

Let’s change the trajectory of sepsis.

The health care system must spend money on improving access to care and improving the coordination of staff and resources available to judge, treat and follow up patients. The multidisciplinary team needs ongoing education and training within the diagnosis and treatment of sepsis, based on the most recent evidence-based guidelines. The public needs further education on sepsis awareness and where to show for help if they can not contact their primary care physician. The CDC recently released them Basic elements of a hospital sepsis program optimizing the identification, treatment and education of sepsis, in addition to increasing the involvement and responsibility of hospital management. AND

As healthcare professionals, we’ve got the facility to initiate change and alter the trajectory of sepsis and sepsis awareness. We must consistently update our knowledge and skills related to the diagnosis of sepsis and guidelines for the management of sepsis. We must teach our patients and their families learn how to advocate for themselves. We must improve access to look after all people so we will stop sepsis from taking one other life.

Centers for Disease Control and Prevention (CDC). (2023, August 24). Basic elements of a hospital sepsis program. https://www.cdc.gov/sepsis/core-elements.html

Centers for Disease Control and Prevention (CDC). (2022, August 9). Â Sepsis technical resources and guidelines. https://www.cdc.gov/sepsis/clinicaltools/index.html

Neilson, H. K., Fortier, J. H., Finestone, P. J., Ogilby, C. M., Liu, R., Bridges, E. J., & Garber, G. E. (2023). Diagnostic delays in sepsis: lessons learned from a retrospective study of Canadian medico-legal claims., (2), e0841. https://doi.org/10.1097/CCE.0000000000000841

Sepsis Alliance. (2023). Sepsis Awareness Month. https://www.sepsis.org/get-involved/sepsis-awareness-month/