We have had a number of enquiries from people in relation to injuries/deaths arising out of infection. On investigating these cases, we have discovered that if an infection is not treated promptly, it can cause an inflammatory response which is known as sepsis. The treatment of this condition is very time sensitive and unless treatment in the form of antibiotics and fluids are implemented promptly, the condition can progress very quickly from sepsis to severe sepsis and ultimately septic shock. We have below set out the details of a recent enquiry which illustrates the fast progression of this condition from high temperature to full blown sepsis and death within a 12 hour period.
One Sunday morning at about 8am, an elderly lady complained that she felt unwell. Her forehead was very warm and her daughter felt as if she had a temperature. However, the lady was complaining that she was very cold. The family immediately took her to A&E. On arrival, they were informed that their mother had a very high temperature and investigations would be carried out to try to establish the cause of the temperature before starting any treatment. Because it was a Sunday, the results took longer to process. In that time, the lady’s condition deteriorated. She started to shiver uncontrollably and her hands and feet were ice cold and ultimately they turned blue. The lady was transferred to the Intensive Care Unit and placed on life support. Her kidneys stopped working and her blood pressure was critically low. A Doctor explained to the family that the infection had caused ‘blood poisoning’ and they were going to give her a combination of very strong antibiotics and other supports in the hope that it would get on top of the infection but that she was critically ill. Unfortunately, the lady never regained consciousness and died a little after at 8pm. The family asked the Doctor if the delay in giving their mother the antibiotics had contributed to her death. They did not get a satisfactory response to this enquiry.
Unfortunately, the mortality rate from septic shock is very high. However, studies have demonstrated that early appropriate treatment improves the chances of survival of this life threatening condition; some studies have quoted figures of 20-30%. There are various guidelines in existence, both international "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock" published in 2004, and domestic guidelines “Sepsis Management - National Clinical Guideline No 6 (HSE guidelines). The common theme is that there are sepsis management guidelines to help diagnose the condition early in order to maximise survival. The guidelines are known as The Sepsis 6 Bundle and from diagnosing sepsis, there are 6 steps are to be taken with 1 hour. There are other care pathways if there is a diagnosis of severe sepsis/septic shock that are recommended.
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