Sepsis – What to look out for

What is sepsis?

Sepsis is a very serious response from your body to an infection that can be life-threatening. Most people make a full recovery once it is diagnosed and treated quickly. If sepsis is not treated promptly, it can cause multiple organ failure and death.

If you think you or someone you take care of is showing signs of sepsis, it is crucial to call emergency services (999 or 112) or go to a medical emergency department immediately.

Sepsis Awareness

The family of Sean Hughes, also known as ‘Lil Red’, launched a health awareness campaign around sepsis back in 2019. Sean was only 15 years old when he suddenly lost consciousness while watching television with his mother in January 2018, after appearing to be displaying symptoms similar to a flu-like chest infection. Sadly, he later passed away in hospital.

Sean’s family had never heard of sepsis before this happened and after doing some research after Sean's passing, were shocked at the low level of public awareness in Ireland around this global medical emergency. They have become heavily involved with the Irish Sepsis Foundation and have raised awareness through “Lil Red’s Legacy Sepsis Awareness Campaign”. Spreading the message across Ireland and beyond that awareness of sepsis saves lives.

You can read Sean’s full story on the Irish Sepsis Foundation page.

Symptoms of Sepsis

It can be hard to tell if you have sepsis symptoms. There are many signs of sepsis and sometimes they are not clear or specific. The signs can be similar to the ones you may experience if you have the flu or a chest infection.

Sepsis only occurs if you already have an infection. There are some early signs and symptoms of sepsis in adults, these include:

• a high temperature (38 degrees Celsius or above)
• low body temperature (below 36 degrees Celsius)
• chills and shivering
• a fast heartbeat
• problems with or changes to your breathing
• feeling or acting differently from normal
• vomiting
• a headache
• feeling unwell

If you have an infection and start getting any of the symptoms above please contact your GP urgently. If your GP thinks it is sepsis they will refer you to hospital for further diagnosis and treatment.

Early signs of sepsis in babies and children under 5 can include:

• a temperature of 38 degrees Celsius or higher in babies under 3 months.
• a temperature of 39 degrees Celsius or higher in babies aged 3 to 6 months.
• a temperature below 36 degrees Celsius - re-check after 5 minutes to confirm.
• difficulty breathing, breathlessness or you notice their stomach moving in and out as they use their stomach muscles to help them breathe.
• no interest in feeding (in babies)
• hasn't drank anything for more than 8 hours when awake.
• vomiting repeatedly.
• blood in their vomit or their vomit is green or black.
• sunken eyes.
• a bulging soft spot on their head.
• no interest in anything, even with encouragement.
• been less responsive, irritable, or difficult to console.
• a stiff neck, especially when trying to look up and down.
• been behaving differently than usual to the point that you are worried.

If your baby or child has an infection and starts showing any of the symptoms above, please contact your GP urgently. If your GP thinks it is sepsis, they will refer your child to hospital for further diagnosis and treatment.

Emergency: If your baby or child shows any of the symptoms below, please contact emergency services or bring them to an emergency department straight away:

• has blue, pale or blotchy skin, lips or tongue.
• has a rash that does not fade when you roll a glass over it, in the same way you check for meningitis.
• is being very sluggish, unusually sleepy and hard to wake.
• feels unusually cold to touch.
• has had no pee or wet nappies for more than 12 hours.
• is breathing very fast.
• has fits or convulsions.
• has a weak, high-pitched cry that's not like their normal cry.
• has an infection, is still unwell after 24 hours or is getting worse - it may be sepsis.

Please remember that there is no one sign, and symptoms present differently between adults and children.

Causes of Sepsis

Sepsis can occur from a few different types of infection. The main reason being a bacterial infection, but it can also be caused by a viral or fungal infection. The most common places where infections start and can cause sepsis are the lungs, urinary tract, and stomach.

Sepsis can affect multiple organs or it can affect your entire body. Usually, your immune system will keep the infection from spreading, this is called a localised infection. If your immune system is weak however, the infection can affect your whole body.

How to know if you have an infection?

The following symptoms may indicate that you have an infection:

• temperature of 38 degrees Celsius or higher
• temperature of under 36 degrees Celsius
• severe uncontrollable shivering
• feeling tired (fatigue)
• loss of appetite
• muscle and joint pain
• vomiting
• diarrhoea

If you think you might have an infection you should contact your GP. Taking paracetamol can help reduce your temperature but it won’t treat the infection.

The types of infection that are most commonly associated with sepsis include:

• respiratory tract infection
• chest infection
• appendicitis
• tummy infections - signs include unexplained pain, swelling or pain getting worse when pressed.
• peritonitis - an infection of the tissue that lines the inside of your tummy.
• urinary tract infection - an infection of the bladder, urethra or kidneys
• genital tract infection - signs include tummy pain, sometimes with smelly discharge.
• cholecystitis - an infection of the gallbladder
• cholangitis - an infection of the bile ducts
• skin infections, such as cellulitis - these can be caused by a catheter that's been inserted through the skin to give fluids or medication.
• wound infections - signs include pain, swelling, heat or redness around the wound.
• infections of the brain and nervous system – such as meningitis or encephalitis
• osteomyelitis - bone infection
• endocarditis - heart infection
• blood infections
• viral infections

How can you help prevent infection and sepsis?

We can't always prevent sepsis because we might not know where the infection came from. There are a few things you can do to try and stop infections from happening in the first place. You should:

• keep up to date with vaccines, particularly for babies, children, people over 65 and pregnant women.
• wash your hands regularly and keep yourself clean.
• clean and care for any wounds.
• follow the instructions when taking antibiotics.
• finish your course of antibiotics, even if you feel better.
• do not ignore symptoms of sepsis.
• do not delay getting medical help if you are feeling unwell.
• do not touch your face, nose and eyes unless your hands have been washed properly.

Anyone who has an infection can develop sepsis. But there are some people who have a higher risk to getting infections that can progress into sepsis. These include:

• babies younger than 1 year
• people age 75 or older
• people who are frail
• people with diabetes
• people with a weak immune system
• people who are having chemotherapy treatment
• women who have just given birth or have recently been pregnant - including those who have had a miscarriage or termination.
• people who recently had surgery.
• people who recently had a serious illness.
• people taking medication that affects their immune system - ask your GP or pharmacist if you are unsure.
• people who have chronic kidney, heart, liver or lung disease.

Sepsis & Pregnancy

Maternal sepsis is a condition where sepsis occurs during pregnancy or within 6 weeks after giving birth, having a miscarriage, or having a termination. It doesn't happen often, but when it does, it can be really dangerous and may even put your life at risk. If you have an infection and think you might be showing signs of sepsis, it's crucial to get treatment as soon as you can.

The signs of maternal sepsis during and after pregnancy can include:

• acting confused, slurring their speech, not making sense or not their usual self
• difficulty breathing, breathlessness or breathing very fast.
• feel pounding in their chest.
• their hands or feet feel cold, clammy and pale.
• feels dizzy, faint or loses consciousness (passes out)
• not peeing as much as normal – for example, not peeing for a day
• a rash that does not fade when you roll a glass over it, in the same way you check for meningitis.
• severe muscle pain
• have severe leg pain or difficulty standing.
• are extremely unwell or feel like there's something seriously wrong.
• are taking antibiotics for an infection and are not getting any better

If you are showing any of these symptoms it is important to seek medical care straight away. Phone emergency services (999 or 112) or go to an emergency department.

Treatment for sepsis

Sepsis and septic shock are serious medical conditions that need immediate attention. If doctors diagnose and treat it early, they can cure it. The best treatment is to start within the first hour of diagnosis. If you have contacted your GP and they think you have sepsis they will send you to hospital.

The hospital will run tests to check if it is sepsis, these may include x-rays, scans and blood tests. The treatment they give you will depend on:

1. where the initial infection is and what caused it.
2. the organs affected.
3. the extent of any damage.
4. how unwell you are.

Doctors commonly treat sepsis with antibiotics. And depending on your symptoms, you may also receive intravenous fluids or oxygen. The origin of the infection will also require treatment.

Most people will make a full recovery from sepsis but it can take time. Some people find they continue to have physical and emotional symptoms for months, or even years afterwards.