What is sepsis?

Sepsis – also referred to as blood poisoning or systemic inflammatory response syndrome (SIRS) – is a life threatening condition that arises when the body's response to an infection injures its own tissues and organs This condition leads to shock, multiple organ failure and death, especially if not recognized early and treated promptly.

In individuals with paralysis, this might begin as a urinary tract (bladder) infection, pneumonia, a wound, pressure ulcer or other infection. If the infection is not controlled locally, it can spread throughout the body.

Septic shock is severe sepsis with a drop in blood pressure leading to organ failure. Both sepsis and septic shock are life threatening. Treatment is most successful within the first hour of onset.

Anyone with an infection must be aware of the risks and symptoms of sepsis and seek medical attention immediately.

General symptoms of sepsis

Some or all of the following symptoms may be present:

  • 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 of sepsis might 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 (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)

What to do

Prevention is the best course of action to avoid the development of sepsis.

Individuals should check with their healthcare 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 these symptoms or body reactions, call or visit your healthcare provider immediately.

Diagnosing sepsis: lab and imaging tests

Typical laboratory and imaging 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
  • 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 which includes supporting bodily functions along with antibiotics to control the spreading of 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 and pain
    • Insulin for high blood glucose
    • Corticosteroids to decrease inflammation
  • 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 is possible. 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 trauma from the sepsis event.

Download a life-saving sepsis wallet card

The good news is, if you know the signs, and are quick to contact your physician when they set in, sepsis is treatable.

In order to help you be as aware as possible about sepsis, and to help your doctor to understand your susceptibility to the condition, the Reeve Foundation Paralysis Resource Center (PRC) offers a convenient and life-saving wallet card to draw immediate attention to sepsis.

Thanks to the collaboration of Linda Schultz, PhD, assistant professor of nursing at Maryville University, and the medical staff at Kennedy Krieger Institute, the sepsis wallet card was designed for both the patient and the physician, and applies to both adults and children.

Easy to fit in your wallet, the card is a tri-fold that will allow you to record your level of injury and include emergency numbers, review symptoms of sepsis, among other important information.

One of the folds is written specifically for the physician. In the event of a sepsis crisis, you can pull the "Attention Physician" flap to the front. This allows first responders to see your personal information on one side, and directions to treat sepsis on the other.

Copies of the sepsis wallet cards are available online for download, or you can get your laminated copy by calling the PRC at 800-539-7309 and asking to speak to an information specialist.

Watch our video on sepsis

Resources on sepsis

For more information on understanding sepsis and additional resources from trusted Reeve Foundation sources, please download our fact sheet on sepsis and check out our repository of fact sheets on hundreds of topics ranging from aging with a spinal cord injury to secondary complications of paralysis.

The information contained in this card and web page 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 healthcare provider should you have questions on your health, treatment, or diagnosis.

This project was supported, in part by grant number 90PR3002, 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.