Sepsis must be treated with more urgency

Sepsis should be suspected in all patients who may have an infection said NICE.

In the first national evidence-based NICE guideline the signs and symptons are presented in clear tables to help clinicians assess the risk. People at high-risk of severe illness from sepsis in primary care should be referred by ambulance to hospital when they can be seen by a doctor or nurse immediately.

Professor Saul Faust from the University of Southampton and chair of the guideline development group, said that sepsis can be difficult to diagnose with certainty. 'We want clinicians to start asking "could this be sepsis?" much earlier on so they can rule it out or get people the treatment they need. The thinking should be similar to considering that chest pain could be heart related. Just like most people with chest pain are not having a heart attack, the majority of people with an infection will not have sepsis. But if it isn’t considered then the diagnosis can be missed.'

A report by the National Confidential Enquiry into Patient Outcome and Death published last year revealed delays in identifying sepsis in over a third (36%) of cases.

Professor Frank Joseph, consultant physician and spokesperson for the Royal College of Physicians said: “This guidance on sepsis is timely and vital for busy clinicians on the front-line of urgent medical care. It outlines the systematic processes that need to be in place to quickly identify and diagnose sepsis. It is vital for patient care that doctors are able to initiate crucial early treatment for sepsis in order to save lives and improve patient outcomes.”

According to the UK Sepsis Trust there are around 150,000 cases of sepsis in the UK each year which causes around 44,000 deaths. The Trust is working with NICE to update their range of clinical toolkits in response to the guideline. Dr Ron Daniels, chief executive of the UK Sepsis Trust, said that the revised clinical tools, together with this guideline, 'provide the most cohesive national strategy to prevent deaths from sepsis in the world'.

Sepsis occurs when the immune system becomes overactive during an infection, causing damage to the body itself. Symptoms include fast breathing or a fast heartbeat, high or low temperature, chills and shivering, and people may or may not have a fever. Severe symptoms can develop soon after, when blood pressure becomes very low, leading to dizziness, disorientation, slurred speech, mottled skin, nausea and vomiting. Without quick treatment, sepsis can lead to organ failure and death.