Oscar winning actress Patty Duke lived an uncommon life. However, her death was caused by an all too common cause: sepsis. More than 258,000 people are killed by the condition each year. "Sepsis is a leading cause of death in patients in the hospital," says Kencee Graves, MD, the associate director of the University Sepsis Initiative at University of Utah Health. "It can make people very sick very quickly."
Sepsis is often described as "blood poisoning," but that is not the case. The condition does not occur on its own, but is triggered by an infection. In Duke's case the infection was due to a ruptured intestine. "Essentially it is the severe reaction that your body can have in response to a life-threatening infection," says Russell Vinik, MD, the chief medical officer at the University of Utah Health Plans. "Sometimes this reaction causes organs to shut down and can even cause death."
Currently, an initiative is underway at University Hospital to reduce the harms of sepsis in patients. It starts with education. "We are working with our providers and nurses to improve their knowledge of sepsis so that they are able to identify it more quickly at the bedside," says Graves.
Part of the education involves recognizing the signs of sepsis. The symptoms of sepsis can vary from chills and fever to shortness of breath. There is also a telltale sign in the cardiovascular system. "Patients in septic shock have low blood pressure," says Vinik. "The body is unable to pump enough blood to the vital organs including brain, heart, lungs, kidneys and liver, and these organs progressively begin to shut down."
The second part of the sepsis initiative involves alerting providers and nurses to these symptoms early. Every hour that sepsis is not caught and treatment is not begun the likelihood of recovery decreases. "We have used our electronic medical record, Epic, to notify nurses and providers of a patient with abnormal vital signs such as temperature, heart rate or blood pressure," says Graves. "They then get a pop-up notification to evaluate that patient for sepsis."
The automatic evaluations for sepsis start immediately after a patient enters the system and will soon track them throughout the course of care. "This intervention is present in our University and South Jordan Emergency Departments," says Graves. "It will be live on all of our acute care units by May 2."
The final piece of the initiative involves timely treatment. "Patients need to be started on antibiotics and fluids immediately," says Graves. "If they are being transferred to University of Utah Hospital from anywhere in the Mountain West we want to make sure treatment is started before they leave their sending facility."
The hope with this initiative is that deaths like Duke's can be avoided. "The key is keeping patients with sepsis from going into septic shock," says Vinik. "If we can do that, sepsis is very curable."
"We hope to avoid septic shock and death from sepsis with this early diagnosis and treatment initiative," adds Graves.