Failure to diagnose sepsis

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Sepsis kills over 300,000 Americans a year making it one of the nation's leading causes of death. The condition kills more people each year than HIV/AIDS, prostate, and breast cancer combined. Sepsis can occur in both children and adults, but those over 65, less than a year old, and those with chronic illnesses or a weakened immune system are most vulnerable. The early diagnosis of sepsis and the administration of antibiotics to patients greatly improves survival rates. If treated early, a patient stands a good chance of making a full recovery. Delayed treatment can lead to tissue and organ damage and even death.

Several states, including New York, revised their public health regulations beginning in 2013 and outlined the proper protocol for hospitals, emergency care providers, and nursing home staff to follow as a means of quickly diagnosing and treating sepsis cases. Since early treatment is key, people need to be aware of the symptoms of the condition in order to know when to seek treatment for themselves or their loved ones. Health care professionals need to be aware of the need for timely diagnosis and treatment of sepsis.

Sepsis is the body's extreme and life-threatening reaction to an infection, If left untreated, the effects of sepsis can lead to tissue damage, organ failure, and death. Bacterial, viral or fungal infections anywhere in the body can cause sepsis. An infection happens when germs enter a person's body due to something as mundane as a scraped knee or a tooth abscess to more serious internal ailments such as a ruptured appendix. Certain infections and germs like E coli and strep that often manifest in a person's lungs, urinary tract, skin, and gut can also lead to sepsis. Sepsis is also one of the most common complication from surgery and the leading cause of death in intensive care units. Nursing home patients are often vulnerable to this condition due to age-related infections, the use of invasive procedures like catheters or the sanitary issues and the close quarters of managed care facilities.

As sepsis becomes more severe as time progresses, health care providers should aim to identify and treat sepsis in its earliest stage. As sepsis worsens, the blood flow to the brain, heart and kidneys can be blocked forming blood clots. Due to the need for rapid diagnosis, treatment of patients with an already critical illness may need immediate attention to prevent rapid deterioration. This often requires doctors and nurses to treat the patient's existing health issues in tandem with evaluating new symptoms and test results for the presence of sepsis.  

The main reason for the high mortality rate is that the symptoms of sepsis are similar to other non-life threatening illnesses leading to a high frequency of health care professionals misdiagnosing patients leading to inappropriate treatment. The symptoms of sepsis are often like the flu or an infection, but there is no single telltale sign. Rather it is a combination of symptoms that become more severe over time including diarrhea, vomiting, sore throat, extreme pain, confusion, and shortness of breath. If you or a loved one has any of these symptoms, you should call your doctor or go to the emergency room and clearly state you are concerned about sepsis. Your doctor should check for a fever and an increased heart and breathing rate. He should also order lab tests to detect an infection and possible sepsis. An abnormal white blood cell count is a common indicator of sepsis. Doctors may also test other bodily fluids specifically urine and saliva for the presence of bacteria and other infectious agents. Additionally, X-rays and scans may be ordered and evaluated to identify or confirm the source of the infection. Hospitals can play a major role in decreasing the number of death from sepsis by adopting standard protocol that promotes early identification and treatment.

On January 29, 2013, Governor Andrew Cuomo of New York announced Rory's regulations named in honor of Rory Staunton who died from sepsis. The new regulations mandated that all hospitals in the state adopt evidence-based protocols for the early diagnosis and treatment of sepsis. New York was the first state in the nation to implement such measures and it has led to faster care and increased chances of survival for sepsis patients. The regulations require hospitals to follow a checklist of procedures within a three-hour window including blood tests, checking blood lactate levels, and beginning antibiotics. Hospitals are required to adopt protocols that facilitate the early screening and diagnosis of patients with sepsis, severe sepsis and septic shock; develop a process to identify individuals needing treatment for sepsis and document the effectiveness of the protocols; and compose guidelines for treatment including the early delivery of antibiotics. The protocols must be submitted to the Department of Health for approval and periodically updated. To inform all hospital staff of the new requirements, hospital administrators must schedule training sessions. Hospital department managers must also collect data regarding the cases of sepsis including the total number of patients diagnosed and treated and the success rate of the treatment. Based on this information, individual facilities must decide if new internal procedures should be implemented to improve the quality of care for sepsis patients and increase the survival rate of those afflicted. Health care providers also must submit this data annually to the Department of Health. This information is used to determine each facilities compliance with the regulations and to assist Department of Health officials in updating their recommendations for the best practices in terms of treating sepsis.

If you or a loved one has suffered long-term health issues or death related to undiagnosed or improperly treated sepsis, contact us today.

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