Authority warns about silent killer sepsis
EAST NORRITON >> You may have heard of sepsis, but do you really know what it is?
A lot of people don’t have any idea that sepsis is a silent killer that is often overlooked simply because of a lack of awareness, according to the Pennsylvania Patient Safety Authority, which has designated September as Sepsis Awareness Month.
Identification and treatment of sepsis at Einstein Medical Center Montgomery in East Norriton has been a longtime project, noted Kimberly C. Mikula, Clinical Director Critical Care at Einstein Medical Center Montgomery, who is in charge of the hospital’s sepsis program.
“September is Sepsis Awareness Month but we’ve been doing this (program) almost forever,” Mikula said. “CMS (Center for Medicare and Medicaid Services) looks at all of our patient outcomes and so we drill down from all of that, making sure that we’re meeting all of the fundamental measures that are aligned with the Surviving Sepsis Camaign.”
According to survivingsepsis.org, the Surviving Sepsis Campaign was founded in 2002 and is a joint collaboration of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM), committed to reducing mortality and morbidity from sepsis and septic shock worldwide.
There are several marketing campaigns going on to increase awareness of the poentially deadly disease, Mikula noted.
“Sepsis can start from any type of infection. It can be a viral infection, a bacterial infection, fungal. Something as simple as a stubbed toe can trigger an infectious response that puts people into a septic shock scenario, which is life threatening. Sepsis itself is a very broad term because somebody can be septic, which means the localized infection has traveled someplace else in their system. Septic shock is when the body has responded so severely that now the blood pressure dropped and the person is unable to maintain their normal vital signs that are life sustaining.”
Much about the disease is still not known, Mikula pointed out.
“It’s gotten more advertisement because of some of the well-known people that have succumbed to sepsis, like (Oscar-winning actress) Patty Duke. When famous people succumb to sepsis there’s a little more opportunity to put public awareness out there,” she said. “When we had the H1N1 flu in 2009, that’s when things became much more publically emphasized to get people starting earlier treatment. When I graduated nursing school back in the ‘80s sepsis was one of those things that an elderly woman coming from a nursing home with a catheter, it was an inlet for infection. You always knew they were going to come in infected and you fought to save them but many of them succumbed. It was generally an old people sickness. But now it’s not. Everybody has the potential to become very sick when you walk into that world of sepsis. It has to do with antibiotic resistance due to sometimes misappropriation of antibiotic usage.”
Treating sepsis is about appropriately treating infections, and not necessarily prescribing an antibiotic for a viral infection, Mikula noted.
. “Our sepsis protocol includes antibiotics if the patient has a bacterial infection. If a patient has septic shock because of a flu we’re not necessarily going to give them antibiotics right away. Lactic acid is one of the things we look at that will show that the patient is not profusing oxygenated blood through their system. If that’s elevated, the risk of death is increased if they dont get that down.”
David Ezdon, Infectious Diseases/Antibiotic Stewardship Pharmacist, Einstein Medical Center Montgomery added: “From a prevention standpoint it’s more about infection prevention as a whole, with appropriate hand hygiene, appropriate cough hygiene. If you’re not getting sick then there’s a lower risk that you’re going to end up in a septic state. Preventing infection is how you prevent sepsis.”
The Pennsylvania Department of Health (DOH) reports that 2,408 people, including babies, young children and healthy young adults died of sepsis in 2017, the last year on record.
In 2018, Montgomery County experienced 5,250 sepsis hospitalizations, costing an average of $22,000 per patient, or a total of $115,500,000, according to DOH, which reported that in Pennsylvania hospitals and nursing homes, significant progress has been made in educating healthcare workers about the impact of this deadly condition and how to treat it
The DOH convened its first conference on stopping sepsis in 2016. In the same year, the PSA began its ongoing sepsis education; to date, PSA infection preventionists have trained almost 600 healthcare workers throughout the Commonwealth.
The mortality rate is coming down in hospitals, from 13.8 percent in 2012 to 9.3 percent in 2017 according to the Pennsylvania Health Care Cost Containment Council.
“What we need most is to combat the lack of public awareness and misconceptions,” noted Regina Hoffman, executive director of the Patient Safety Authority.
. “Too many people have never even heard of sepsis, and many others believe that the only way you can contract it is in a healthcare setting. That simply is not true.”
Hoffman reiterated Ezdon’s comments about practicing good hygiene, in addition to getting recommended vaccines such as an annual flu shot, and staying home when you feel ill.
Nationally, the Centers for Disease Control and Prevention reports that 270,000 Americans die annually as a result of sepsis, second only to heart disease and cancer. It is also the costliest condition treated in U.S. hospitals according to the Agency for Healthcare Research and Quality.
“It’s time for everyone to realize the terrifying impact of this deadly condition, recognize its symptoms, and work to prevent it,” Hoffman said. “Anyone can get an infection, and almost any infection can lead to sepsis. Everyone can do something about it to prevent more tragedyand heartbreak.”