It’s an illness that can cause serious complications, or even death. Several hospitals in northwest Kansas are taking steps to treat it as seriously as a heart attack or stroke.
But sepsis is an illness many residents might not know much about. Area health officials are hoping to change that by increasing public awareness and taking steps to identify and treat sepsis patients as quickly as possible.
Sepsis occurs when a bacterial infection gets out of control, causing serious illness and potentially affecting entire bodily systems.
“Those IV antibiotics are as important to the sepsis patient as the defibrillator is to the patient who’s in defib,” said Carol Groen, manager of clinical operations at Hays Medical Center. “If your sepsis patient is going to survive, we’ve got to get those antibiotics to them quick. It can be a matter of life and death for those patients.”
Both HaysMed and Rooks County Health Center in Plainville have been working for years to implement treatment protocols for suspected cases of sepsis, allowing medical staff to begin care immediately.
RCH was a statewide forerunner in writing a list of treatment protocols that staff now use in these cases. The standing orders — implemented in 2011 — allow nurses and other medical team members to begin taking steps immediately, which is especially important if the on-call emergency physician is 30 minutes away, said Stephanie Bjornstad, quality coordinator and risk manager at RCH.
It’s important to administer antibiotics and fluids quickly, as well as to obtain necessary lab work to confirm the diagnosis.
Data from University of Kansas Medical Center illustrates how the mortality risk increases the longer it takes for patients to receive antibiotics. The goal is to administer the medicine within the first hour, when the risk of death is less than 20 percent, Bjornstad said.
That mortality risk jumps to 50 percent when the illness goes untreated for six hours. It’s unlikely a patient would survive if treatment is not received within 36 hours, according to the data.
For Bjornstad and the RCH medical staff, it was that information shared in a powerpoint presentation that made the issue really hit home.
“Time is of the essence, so we run it like a code,” she said. “It’s like you’re having a heart attack is how we run it. It’s that serious, and time is that important.”
Signs of sepsis can be subtle, but patients and caregivers usually are aware something isn’t right, as victims are likely to feel very ill. Early symptoms can include fever or low body temperature, rapid breathing, altered mental status and accelerated heart rate. Blood work also might show an abnormal white blood cell count or confirm high levels of lactic acid.
While the elderly, infants and those with compromised immune systems are considered most at risk, sepsis can strike anyone at any time, said Dr. Kayla Gray, sepsis medical director at HaysMed.
“Sepsis has always been around, now we’re giving a name to it. So it raises awareness not only in the medical community, but also in the general population,” Gray said.
“Sepsis doesn’t care about your age, it doesn’t care about your sex, it doesn’t care about your socioeconomic background. It affects all.”
It also is a leading cause of death for newborns, who still have immature immune systems, and is more of a risk to patients with implanted devices.
Any untreated infection, from an ingrown nail to strep throat, can increase the risk of developing sepsis. It’s important for patients to get seen by a medical professional if they have symptoms of bacterial infection, and to follow-up if given an antibiotic that doesn’t seem to be helping, Groen said.
And if sepsis is suspected, residents should seek immediate emergency care rather than waiting at home.
HaysMed fully implemented its sepsis protocols approximately three years ago, and now is working with KU Med to help increase awareness at regional Critical Access Hospitals and long-term care facilities.
Early sepsis treatment is becoming more common nationwide, as the federal Centers for Medicare and Medicaid Services is starting to encourage it, Bjornstad said. RCH officials are grateful they were among the state’s early adopters and also began by working with KU Med, which has a “surviving sepsis” campaign.
“We’re very happy and proud that we were very much a forerunner,” she said. “For us to be a Critical Access Hospital and to be a forerunner was extra exceptional.”
Hospital staff now wear cards on their lanyards that list the exact steps to take for sepsis care, and regular training is offered, she said.
Area patients always have come to the hospital with sepsis, but only in recent years has the illness been clearly identified as an urgent, time-sensitive matter. Initially, RCH staff weren’t sure how many sepsis cases they actually were seeing, Bjornstad said.
“I think we did a six-month look back and found it was around 40 cases that we didn’t recognize as sepsis,” she said. “Because we just didn’t have that education at that time.”
Since then, the percent of sepsis patients quickly identified and treated has increased significantly, she said.
HaysMed also is seeing better outcomes. In 2015, approximately 500 patients were diagnosed with sepsis. That number increased to approximately 580 last year, and 2017 is on track to be even higher.
That likely isn’t because more patients are getting sepsis, but rather more patients are being correctly diagnosed, Groen said.
“Once sepsis takes place, for every hour of delay in treatment, we increase their mortality by 8 percent,” she said. “It is so important to recognize sepsis early and begin treating it aggressively early before it gets to severe sepsis or septic shock stage, where it becomes very easy to recognize but extremely difficult to treat.”