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Spinal Cord Injury Paralysis Resource Center

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Sepsis

- Request a FREE laminated sepsis wallet card
- Download a FREE PDF fact sheet about sepsis
- Read about a real-life experience with sepsis

Sepsis is a life threatening condition that arises when the body's response to an infection injures its own tissues and organs. Sepsis leads to shock, multiple organ failure and death -- especially if not recognized early and treated promptly. In individuals with paralysis/spinal cord injury, an infection might begin as a urinary tract (bladder) infection, pneumonia, or as a wound, pressure ulcer or other infection. If the infection is not controlled locally, it can spread throughout the body. Sepsis is then diagnosed. Septic shock is severe sepsis with a drop in blood pressure leading to organ failure. Both sepsis and septic shock are life threatening. Sometimes sepsis is called blood poisoning or systemic inflammatory response syndrome (SIRS).

Sepsis can occur due to a spreading infection in the body, after surgery or invasive procedure, or from a simple cut or scratch.

Sepsis is a medical emergency that must be treated immediately. Anyone with an infection must be aware of the risk of development of sepsis. Treatment is most successful within the first hour of onset.

General symptoms of sepsis
Some or all of the following symptoms may be present:
- Presence of infection or possible infection
- Elevated temperature, greater than 38.30C or 101.30F
- Fast heart rate, greater than 90 beats per minute
- Fast respiratory rate, greater than 20 breaths per minute

Other symptoms that may be present:
- Confusion or coma
- Edema especially in the extremities, neck, face
- Elevated blood sugar without diabetes
- Lower temperature below 36C or 97F

Diagnosis might also include components of these variables:
- Inflammation at the site of the initial infection or anywhere in the body
- Inability to maintain internal blood pressure to ensure that enough oxygen-carrying blood reaches all vital organs
- Tissue perfusion, lack of oxygen to any part of the body, most readily seen in the fingers/arms, toes/legs

Sepsis is diagnosed when there is an infection somewhere in the body AND one of the following:
- Organ dysfunction, failure of any internal organs
- organ dysfunction (organ failure)
- hypoxemia (inability to circulate oxygen to your tissues)
- oliguria (decreased urine output)
- lactic acidosis (drop in blood oxygen)
- elevated liver enzymes (liver dysfunction)
- altered cerebral function (confusion/coma)

Sepsis Wallet Card

What to do
Prevention is the best course of action for avoiding the development of sepsis.

Individuals should check with their health care provider for any infection that is not improving or seems to be increasing in symptoms such as redness, swelling, discomfort, pain, localized heat over the affected area or fever/chills. If you have an infection and experience any symptoms of increasing infection or body reactions, call or visit your healthcare provider immediately.

Tests
Typical laboratory tests for infection are:
- Urine test for bacteria
- Wound cultures for bacteria
- Nasal or oral secretions for bacteria
- Blood tests for bacteria, clotting factors, cardiac, liver and kidney function, oxygenation or electrolytes

Imaging Studies
Body scans might be done to assess internal organ function. These scans might include:
- X rays
- CT scans (Computerized tomography)
- Ultrasound
- MRI (Magnetic resonance imaging)

Treatment
Treatment is provided by experts in a hospital setting. Treatment includes support of life sustaining bodily functions along with antibiotics to control the spreading infection.
- Antibiotics are provided to control the infection.
- Typically, individuals with sepsis or septic shock will receive IV fluid therapy and oxygen.
- Medications are provided according to the individual’s symptoms such as: medication to control blood pressure, insulin for high blood glucose, corticosteroids to decrease inflammation, and medicine to control pain.
- Therapy is indicated for supportive care to maintain and restore function.
- If the respiratory system is affected, mechanical ventilation may be required.
- If kidney failure is present, dialysis may be required.

Recovery
Recovery from sepsis can occur. Many individuals recover without any residual dysfunction. Some sepsis survivors will have long-term recovery needs based on organ or tissue damage from the septic event. If there is severe trauma to the extremities, amputation may be performed. Some patients have post-traumatic stress syndrome, a mental health condition, as a result of the trauma of the sepsis event.

The information contained in this card is presented for the purpose of informing you about paralysis and its effects. Nothing contained herein is to be construed or intended as a medical diagnosis or treatment. Contact your physician or other qualified health care provider should you have questions on your health, treatment, or diagnosis.

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Arkansas Spinal Cord CommissionThe mission of the Arkansas Spinal Cord Commission is to administer a statewide program to identify and meet the unique and lifelong needs of people with spinal cord disabilities in the state.

CareCure CommunityCareCure Community features a SpinalNurse bulletin board with informed comments on matters of the bowel, and all issues of paralysis.

Canadian & American Spinal Research OrganizationPromotes and supports funding research to ultimately find a cure for paralysis. Also publishes journal of latest research they fund. Call (800) 361-4004 or use the link above.

Canadian Paraplegic AssociationAssists people with spinal cord injuries and other disabilities to achieve individuality, self-reliance and full community participation. Call (613) 723-1033 or use the link above.

Craig HospitalWith funding from the US Department of Education's National Institute on Disability & Rehabilitation Research, has developed educational materials to help people with spinal cord injuries live in the community maintain their health. Topics include skin care, exercise, heart disease, weight control, alcohol abuse and conditions related to the aging body. Use the link above and click on SCI Health and Wellness.

Determined 2 HealProvides helpful information for the newly spinal cord injured.

FacingDisability.comFacing Disability is a web resource with more than 1,000 videos drawn from interviews of people with spinal cord injuries, their families, caregivers and experts. I know that this is a lot to ask, but we'd be so grateful for your help. I'm looking forward to discussing this link with you, and to answering any questions you may have.

Model Systems CentersA federally funded program of 14 specialty medical and/or rehabilitation centers across the US. The SCI Care System collects and submits acute, rehabilitation and follow-up (annual, long-term post-discharge) data on SCI patients who received care in the these centers following injury.

The Miami Project to Cure ParalysisThe Miami Project to Cure Paralysis has studied functional electrical systems for exercise.

The National Spinal Cord Injury Statistical Center (NSCISC)NSCISC supervises and directs the collection, management and analysis of the world's largest spinal cord injury database. Headquartered at the University of Alabama, Birmingham.

National Spinal Cord Injury Association (NSCIA)At NSCIA, we educate and empower survivors of spinal cord injury and disease to achieve and maintain the highest levels of independence, health and personal fulfillment. We fulfill this mission by providing an innovative Peer Support Network and by raising awareness about spinal cord injury and disease through education.

New York Online Access to Health (N.O.A.H)Offers information and links related to spinal cord and head injury treatment, rehabilitation, and children. Materials in Spanish.

Neuroscience for KidsOffers an understandable look at the segments of the spinal cord; from University of Washington.

Paralyzed Veterans of America, in support of The Consortium for Spinal Cord Medicine, offers authoritative clinical practice guidelines for bladder management. Consumer guides are available to download.

SpineUniverseAt SpineUniverse our goal is to help patients and their families understand their back or neck problems. In clear, straightforward language we aim to explain what causes spinal problems and how they can be treated. We are committed to ensure that all of the information we present is trustworthy and of the highest quality.

Spinal Cord Injury Information NetworkThe Spinal Cord Injury Information Center features clinical information about bowel management and all other medical issues of paralysis.

United Spinal AssociationOur mission is to improve the quality of life of all Americans living with spinal cord injuries and disorders (SCI/D), including multiple sclerosis, spina bifida, Lou Gehrig’s Disease (ALS), and post polio.

U.S. Department of Veterans Affairs Fact Sheet: VA and Spinal Cord InjuryOf the more than 250,000 Americans with serious spinal cord injuries and disorders, about 42,000 are veterans eligible for medical care and other benefits from the Department of Veterans Affairs (VA).

Paralysis Resource Center The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET. You may also schedule a call or send a message online.

Reeve Foundation Online Paralysis Community Connecting people living with paralysis, families, friends and caregivers so we can share support, experience, knowledge, and hope.

Quality of Life Grants DatabaseFind resources within the PRC Quality of Life Grants Database. Search by Zip Code, State or an Entire Category.

Library Books and VideosFind resources within the PRC library catalog.

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The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm Eastern U.S. Time. International callers use 973-467-8270. You may also schedule a call or send a message online.

This project was supported, in part by grant number 90PR3001, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.