Health and Wellness: UNC Health Johnston seeks to raise awareness about sepsis

Submitted by UNC Health Johnston

When Lee Stikeleather of Four Oaks started out as a nurse 30 years ago in Wake County, hospitals didn’t have specific care plans for treating sepsis. Back then, it was called urosepsis and viewed as a complication of urinary tract infections, he said.

“Most of the patients were aged and arrived at the emergency department with low blood pressures and altered mental states,” he said. “We did what we could. But many were so sick we couldn’t save them.”

In the years since, health care professionals have come to understand and treat sepsis as a medical emergency. Most notably, in 2015, the Centers for Medicare and Medicaid Services implemented a national quality measure that required hospitals to provide a bundle of care to patients with possible sepsis within three hours.

These tasks included starting IV fluids, ordering blood cultures and lactate levels — all within the first hour of the patient’s arrival. If the results showed the patient had sepsis, then treatment with broad spectrum antibiotics began right away.

WHAT IS SEPSIS?

Sepsis the body’s overwhelming and toxic response to infection. Every year in the U.S., sepsis kills more than 350,000 adults and is the leading cause of readmissions and death in hospitals, according to the Sepsis Alliance.

Stikeleather, a quality assurance specialist at UNC Health Johnston, leads a sepsis team that works with the UNC Health system to ensure the most up-to-date practices are put into place as quickly as possible.

Improving sepsis care has become part of the norm, he believes.

“Electronic tools within our charting system give providers quick access to information, diagnostic orders and treatment regimens based on the latest evidence-based practice,” he said. “We’re working with sepsis experts across the UNC Health system to refine and redesign these tools to be more user friendly and as efficient as possible.”

The emergency departments in Smithfield and Clayton see about 80 cases of sepsis every month, and roughly 12 percent of those patients don’t survive, Stikeleather said. “We still have a long journey ahead of us with sepsis, but we are saving more lives than ever and will continue to do so.”

The Sepsis Alliance notes that 80 percent of sepsis deaths could be prevented with rapid diagnosis and treatment. For every hour treatment is delayed, the risk of death increases by 4 to 9 percent. “That’s why it’s so critical that people know the symptoms and understand the urgency to seek medical care,” Stikeleather said.

The Sepsis Alliance has a slogan and acronym that makes the symptoms easy to remember. It’s about TIME. Watch for: a temperature higher or lower than normal; signs of an infection; mental decline such as feeling confused or sleepy; extremely ill with symptoms such as severe pain, discomfort or shortness of breath.

The Alliance encourages patients who are experiencing any of the symptoms to seek urgent medical care and to ask their medical provider if their illness could be sepsis.

While sepsis can affect anyone, some groups are more susceptible, the Alliance says. Those include young children, older adults and those with a weakened immune system.