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Sepsis

WHAT YOU NEED TO KNOW:

Sepsis happens when an infection spreads and causes your body to react strongly to germs. Your body's defense system normally releases chemicals to fight off infection at the infected area. When infection spreads, chemicals are released throughout your body. The chemicals cause inflammation and clotting in small blood vessels that is difficult to control. Inflammation and clotting decrease blood flow and oxygen to your organs. This may cause your organs to stop working correctly. Sepsis is a life-threatening emergency.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Monitoring:

Healthcare providers will closely monitor your blood pressure, heart rate, breathing rate, and temperature. They will also ask you about your pain. You may need any of the following:

  • A central venous access device is also called a central line. It is an IV catheter. It is put into a large blood vessel near your collarbone, in your neck, chest, or in your groin. The central line may be used to give medicines or IV fluids, and to draw blood samples. It may also be hooked up to a monitor to take pressure readings near your heart. This information helps healthcare providers monitor your heart and how well you are hydrated.
  • An arterial line is an IV that is inserted into an artery in your wrist, arm, or groin. It records your blood pressure. The readings are displayed on a monitor. The tube is attached to a monitor that keeps track of your blood pressure. An arterial line may also be used to take blood samples.
  • A heart monitor is an EKG that stays on to record your heart's electrical activity.
  • A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. An alarm will sound if your oxygen level is low or cannot be read. Never turn the pulse oximeter or alarm off.
  • A neurological exam is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show healthcare providers how well your brain is working during your illness. Healthcare providers may check your neuro signs every hour.
  • Intake and output may be measured. Healthcare providers will keep track of the amount of liquid you are getting in your IV. They also need to know how much you are urinating. They may keep track of your urine output by inserting a urinary catheter. A urinary catheter is a small, flexible tube that is inserted into your bladder to drain your urine. Ask healthcare providers if they need to measure or collect your urine.

Medicines:

  • Blood pressure medicine increases your blood pressure. This medicine will also increase blood flow to your organs.
  • Heart medicine controls or lowers your heart rate.
  • Glucose increases your blood sugar level.
  • Insulin decreases your blood sugar level.
  • Acid-lowering medicine helps prevent stomach ulcers.
  • Blood thinner medicine helps prevent blood clots.
  • Antibiotics treat a bacterial infection. You may be given more than 1 type of antibiotic.
  • Antifungals treat a fungal infection.
  • Sedatives help you relax and feel calm. These may be given if you are on a ventilator.
  • Pain medicine may be given. Do not wait until the pain is severe before you ask for more medicine.

Treatment:

  • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.
  • Removal or change of a catheter or drain may be needed to get rid of the infection.
  • Mechanical ventilation may be needed if sepsis prevents your lungs from working correctly. A breathing tube or endotracheal tube (ET tube) is a hollow plastic tube that is placed in your trachea through your mouth. The trachea is also called the windpipe or airway. The ET tube is attached to a machine called a respirator. A respirator gives you oxygen and breathes for you when you cannot breathe on your own. You will be given medicine to make you sleepy and more comfortable.
    Proper Endotracheal Intubation
  • Nutrition support may be needed if you cannot eat normally. During treatment you may not be awake, or you may have an ET tube that prevents you from eating. A feeding tube may be inserted. A feeding tube is a thin tube that is inserted through your nose or mouth into your stomach or small intestine. Formula can be injected through the feeding tube. You may instead need nutrition through your IV.
  • Pneumatic boots may be applied to your legs. The boots have an air pump that tightens and loosens different areas of the boots. This improves blood flow and helps prevent clots. Sepsis can increase your risk for blood clots.
  • A blood transfusion may be needed if bleeding occurs or platelet levels drop. This can happen in severe sepsis.
  • Dialysis may be needed if your kidneys stop working correctly or are damaged during sepsis. Dialysis is a procedure to remove chemicals, wastes, and extra fluid from your blood.
  • Surgery may be needed to treat problems causing sepsis. This may include removing an abscess or infected tissue.

Tests:

  • An x-ray, ultrasound, CT, or MRI may show the source of infection. You may be given contrast liquid to swallow or in your IV to help the infection show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to any type of contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • Blood and urine tests will show infection, organ function, and give information about your overall health. A blood test may also show what germ is causing your illness.
  • Blood gases will show how much oxygen and carbon dioxide is in your blood. The results will tell healthcare providers how well your lungs, heart, and kidneys are working.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart. The test will also check for damage to your heart valves that may be caused by infection.
  • A lumbar puncture (spinal tap) may be done to test your cerebrospinal fluid (CSF) for germs. It can also check for signs of infection in or around your brain. CSF is the fluid that surrounds your spinal column and your brain.

RISKS:

Without treatment, sepsis may develop into septic shock (sepsis with low blood pressure). Multiple organs may shut down. These problems can be life-threatening. Your organs may be permanently damaged by septic shock.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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