Sepsis Reminder

Posted by Nurse Linda in Life After Paralysis on April 01, 2022 # Health

doctor and patient There are many concerns to think about daily such as bowel, bladder and skincare. However, a concern that should be in the back of your mind is sepsis. It is not something to constantly be fretting about, but when symptoms appear, it is critical that they are recognized, and treatment is started early. Sepsis is a dangerous healthcare issue that can affect anyone at any time, not just those with neurological disease, although issues with the nervous system can increase the possibility of acquiring sepsis.

Sepsis is a body’s response to infection that is so extensive that the natural and usual infection-fighting processes cause damage to healthy tissues. An individual can have an infection anywhere in the body, get treatment, and move on with their life. Infections treated early have less chance of evolving to sepsis. However, some infections move swiftly through the body and can quickly become septic. Other infections can linger for a while before turning septic.

Anyone can develop sepsis. As bacteria and viruses become stronger, sepsis has affected many individuals without health issues. Stories are seen and heard in news items about people picking up a germ in the gym, then developing sepsis. Before they even know it, they are ill.

Some risk factors can increase your chances of an infection developing into sepsis. These include very young individuals such as infants, older individuals, those with chronic health conditions and individuals who are immunocompromised. Also at risk are people with neurological diseases from medical causes or injury. Individuals with neurological concerns that affect the autonomic nervous system (ANS) are at risk because the ANS may be slow to respond to recognize an invader in your body, slow to respond to an infection, or may not respond at all. This can include those with spinal cord injury, brain injury, or neurological diseases.

All infections anywhere in the body are potential sources of sepsis. However, secondary complications of neurological diseases such as diabetes increase risk factors as well. Infections that occur in the lungs due to decreased muscle function (pneumonia), bladder infections from catheterization or indwelling catheters, or open pressure injury from decreased sensation can lead to sepsis. Due to lack of sensation, an individual may not realize they have an infection somewhere in their body, which allows more time for it to develop into sepsis.

Symptoms of sepsis can be rather vague or outright.

  1. Changes in body temperature, increased or decreased from your normal is a symptoms. This may be hard to recognize in individuals who have body temperature regulation issues.
  2. An infection from bacteria, virus, or bug bite (parasite) is another symptom. If you have sensation issues, you may not recognize the usual signs of infection but will need to view your body to notice symptoms of an area of infection, which are redness, swelling (edema), or warmth over the area. Internal infections may have symptoms of chills, sweating, cough, sore throat, mouth sores, shortness of breath, congestion, stiff neck, fatigue, swollen lymph nodes, or headache, among others.
  3. Your mental status may change to sleepiness, confusion, or difficulty waking up.
  4. You may have signs of being ill such as discomfort, extreme pain, or difficulty breathing.

The progress of sepsis follows a process in the body. The steps can develop over time or can occur in an instant. This is why treating an infection is critical, as you do not want sepsis to occur in your body. Sepsis begins with an infection that is localized but spreads, especially into the bloodstream. The infection may be identified or unknown. The immune system will respond to fight the infection. However, the infection may overwhelm the immune system, or in the case of some neurological issues, the immune system may not respond or respond quickly. This allows the infection to spread throughout the body, leading to organ damage, failure, and possibly death.

Severe sepsis includes organ damage, hypotension (low blood pressure) and lactic acid in your blood from tissue breakdown. Septic shock is severe sepsis. Sepsis will attack your internal organs such as your brain, heart, kidneys, liver, and any other organ. It also causes blood clots which may lead to amputation of fingers, toes, and entire limbs.

Sepsis is a medical emergency. If you have symptoms, call 911. Most individuals with sepsis will require treatment in the ICU. This is NOT a wait-and-see issue. Get help right away. Although medical treatment of sepsis is rapid, traditionally one hour, known as the golden hour, one should undergo treatment before significant damage to the body occurs.

Keeping an infection from becoming septic is important. Early detection of septic symptoms needs to be noted. However, providing care for yourself is critical before sepsis is suspected. If you have an infection, seek treatment to ensure sepsis does not develop. Early treatment of infection results in quicker treatment for resolution as well as reduces your risk of sepsis.

Good prevention from sepsis is to maintain your body by washing your hands or your caregiver washing their hands before personal care such as bathing, eating, or other care. Bacteria love to live in moist places of the body or wet items such as damp towels. Use clean towels to dry your body. Use hygiene prior to any invasive activities such as catheterization or bowel care. Keep any openings on your body clean, including anatomical openings but also cuts, scrapes, surgical openings, rashes, and pressure injuries. Check your skin frequently to prevent pressure injury from leading to an opening in your skin. Keep your equipment clean and sanitized.

The inside of your body also requires hygiene. Cough and deep breathe to keep your lungs clear. If you use mechanical ventilation, use the sigh button to take a deep breath to open tiny parts of your lungs. Suction when necessary. Perform pressure releases to avoid pressure injury. Turn your body at night. Use pressure dispersion equipment but do not rely on it to do all of the pressure releases that you need. Tilt your body if you have that function on your wheelchair. Check where equipment touches your body for pressure injury in unusual spots. Inspect your skin frequently to look for pigmentation changes which is the start of a pressure injury and stay off the area until pigmentation returns to your natural color. Hydrate your body with water according to your fluid management program.

Protect your body from injury by carefully handling parts of your body with sensation issues. Move your body safely during transfers. Avoid rough travel surfaces where you might tip your chair or stumble with a walker. Handle hot items such as food or when cooking carefully so as not to burn yourself. Protect yourself from extreme weather, including cold, hot, and humid.

Sepsis is an extreme issue that requires immediate treatment. It is not one that frequently occurs; however, much more of it has been seen with COVID-19 infections. It is something to be aware of so you can receive the treatment you need should you develop symptoms. If you are unsure, call for help. Sepsis should not be taken lightly.

Pediatric Consideration:

Children do not have the frame of reference to determine when they may have symptoms of sepsis, therefore they may not be able to tell you they are feeling unwell. Many of the symptoms of sepsis can be confused with normal childhood care, such as being tired at naptime. As a parent or caregiver, you are adept at reading your child’s behavior. Any decline in mental status warrants investigation, along with other symptoms of change in body temperature, pain, discomfort, or shortness of breath are indications, especially if an infection is present.

Sepsis in anyone can appear in a moment or over time. Children’s conditions change in moments as well. As a parent or caregiver, you are in the best position to know when their health has changed. As always, you are your child’s first line of defense. Asking about sepsis puts the idea in the mind of the healthcare provider, which can result in a quicker response.

Linda Schultz is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

In our community, Nurse Linda is a blogger where she focuses on contributing functional advice, providing the "how-to" on integrating various healthcare improvements into daily life, and answering your specific questions. Read her blogs here.

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The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.