September is Sepsis awareness month with Friday 13th September 2024 being World Sepsis Day. Certainly, this year has been a year of increased sepsis awareness for me. As a microbiologist by training, I was aware of sepsis, I’d been in lectures about it and knew just how serious it could be. But as time goes by and life goes on, that knowledge loses its shine a little and the rust creeps in. That all changed earlier this year when the parent of a dear friend passed away due to sepsis. Suddenly it all came rushing back. Including just how SUDDEN sepsis can be. Ultimately it was just 2-3 weeks for things to go from absolutely fine to… gone. It was heart-breaking. Just a month or so later another dear friend’s parent came incredibly close to losing their life to sepsis. Thankfully it was spotted in time and intervention administered. But only just. That friend, who is a clinical educator decided that things had been too close and also that this incident was not uncommon enough. Too many people are lost to sepsis. Indeed, every HOUR in the UK 5 deaths are due to sepsisi. Sepsis accounts for 11 million deaths globally. We are not talking about a rare situation. And yet how much do we talk about it? So, I was honoured to be invited to attend a conference all about Sepsis organised by Mags Guest, Clinical Educator at HMT St Hugh’s Hospital, Grimsby and Kelly Storey Critical Care Outreach Lead Nurse at the Northern Lincolnshire and Goole NHS Foundation Trust. And wow I learnt a lot. Firstly, I learnt how much the healthcare professionals in my area want there to be better outcomes for patients with sepsis. Such a vast range of healthcare professionals came together in the same room – from GPs, nurses, Emergency Medicine specialists to Infectious Disease specialists – all of them keen to work together to improve the care. Secondly, I was bowled over by the facts and figures surrounding sepsis, effectively delivered by Dr Ron Daniels, CEO of the UK Sepsis Trust whose message had a huge impact on me. 11 million global deaths. 43% of sepsis survivors are not back at work even 12 months later. The fact that otherwise healthy people can go from a “normal” infection and suddenly develop sepsis and become so incredibly unwell. The effects even on those that survive sepsis are often life changing – including for MP Craig Mackinlay, who’s care was as good as it could have been and yet he had to have his hands and feet amputatedii. This is a devasting illness. As the UK Sepsis Trust says: There is no single sign or diagnostic test and sepsis is indiscriminate: while it primarily affects very young children, older adults and people with underlying health conditions, it can sometimes be triggered in those who are otherwise fit and healthy. Sepsis always starts with an infection, such as chest infections or UTIs. It is not known why some people develop sepsis in response to these common infections whereas others don’t. But this is not a new story (at least not to those in the healthcare world!). There have been sepsis guidelines like NEWS – the National Early Warning Systemiii which was then updated in 2017 to NEWS2. There are stories like Martha’siv which has led to the NHS bringing in a new guideline in April 2024 called Martha’s Rule. Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier. In response to this and other cases related to the management of deterioration, the Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’; providing round the clock access to rapid review of a second care team if any family, carer or staff is worried about a person’s condition. Sepsis is a known problem in healthcare – so why, despite previous interventions does it remain a problem? Then I started to see where some of the issues lay. Some of them won’t be surprising – lack of staffing is a HUGE issue, with the NHS suffering from long-term underfunding and attention. Ultimately meaning that sometimes patients aren’t monitored closely enough, or signs are missed due to tiredness. There are also unavoidable issues such as the length of time the tests take to run, to identify the type of microbe causing underlying infection – ultimately, it’s not just the lab capacity and distance that restricts the timeliness of findings, but also the fact that it can take 3 days for the microbe to grow enough for us to test it. Other issues were more nuanced. Such as trying to understand the right balance between treating (potential) sepsis and reserving antibiotics to reduce antibiotic resistance. Solutions. Ultimately you can’t fight sepsis until you can fight the underlying infection. Dr Kate Adams, Consultant in Infectious Diseases at Hull University Teaching Hospital shared what her team have done to identify recommended antibiotics to treat the underlying infection that take into consideration the local area antibiotic resistance patterns. By understanding the origin of the infection (e.g. cut vs. a UTI vs. chest infection), you can often predict what type of microbe needs to be treated. e.g. UTIs will be caused by one set of microbes, and chest infections another. By understanding the medical history, GPs and consultants can administer the right antibiotics in a quicker timeframe – without needing to wait for the test results to come back. This also saves broad spectrum antibiotics for situations where the source of the underlying infection is unable to be determined, reducing the risk of antibiotic resistance building up to our most powerful weapons. Solutions also came in the form of agreements to set up a Local Working Group focused on better education about sepsis. Our area is lucky to have such a close-knit group of professionals across all sorts of disciplines which makes me very hopeful for the future of sepsis care in our area. I came away from the conference better informed, more aware and more hopeful for the future of sepsis care. I also came away a passionate advocate for increasing awareness and discussion of sepsis, so everyone is aware of things like Martha’s Rule and of the Sepsis care guidelines. You can be a lifesaver too. Take a look now and get Sepsis Savvy! Apply Now!