As an RN clinical educator and member of the Sepsis team at CRH, Courtenay Morris is quite familiar with the signs of sepsis. Even so, she was shocked when her husband, Frank, was diagnosed with it after a two-month recurring bout with a urinary tract infection. “I was really shocked at how quickly it progresses,” she said. “I thought I knew a lot about sepsis, but being on the other side of it, with a patient you love and care about, it really brought it home how quickly and scary it got to a critical point.”
Sepsis is an overwhelming and potentially life-threatening response to an infection that can lead to tissue damage, organ failure, and even death. September is Sepsis Awareness Month – a time to learn about the condition and recognize the signs of it.
On a hike while vacationing in New Hampshire, Frank complained of discomfort. After returning from picking up an antibiotic for him, Courtenay said Frank told her he needed to go to the hospital immediately. “The look on his face was absolutely just shocking to me – I’d never seen him look that way before,” she said. By the time they arrived at the emergency department, Frank had become disoriented, could hardly walk, and could not put on his shoes, so he walked into the hospital barefoot.
Once inside the emergency department, Frank continued to struggle with walking, so Courtenay got a wheelchair, which meant she had to help Frank, who is much taller and bigger than Courtenay, into the chair. While in the waiting room, Frank continued to talk about and see things that did not make sense.
It was when they were brought into the triage area that a nurse practitioner called for a sepsis code. Hearing that Frank’s temperature was 101 degrees, his heart rate was in the 140s, and his respirations were high, along with a possible UTI, signaled sepsis to her. A nurse inside the patient area directed them to a cardiac room, which frightened Courtenay, not knowing what would come next. After Frank’s blood was drawn and fluids were administered, the nurse practitioner returned. At that point, Frank couldn’t tell her his name or his birth month.
After spending four days in the hospital, Frank fully recovered. Courtenay feels that what happened to her husband was a good reminder that sepsis can be missed and the importance of looking for the signs. Patients must meet two of the following criteria, along with having a known/suspected infection, to be diagnosed with sepsis: an elevated heart rate, elevated respiratory rate, a high or low temperature, or high or low white blood cell count. “When that NP heard his vital signs, combined with the infection I told them about, she immediately recognized the signs that it could be sepsis. That was really important,” Courtenay said.
More often, patients come in through the emergency department showing signs of sepsis, but they can also develop sepsis while in the hospital. Courtenay said it is especially important to look for a decline in a patient’s condition during their hospital stay. “We are penetrating their best defense. We do a lot of necessary things that put them at a higher risk [for sepsis],” she said, referencing catheters, central lines, and wound care. “The sooner the better with sepsis – recognizing it quickly is going to be the key,” she said.
