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With sepsis on the rise, know the warning signs

As cold and flu season approaches, experts at Northwestern Medicine Delnor Hospital in Geneva are raising awareness about the signs and symptoms of sepsis, a life-threatening full-body response to an infection. Sepsis can cause many problems in the body that can lead to tissue damage, organ failure or death if not treated.

Sepsis happens when an infection triggers an inflammatory chain reaction throughout the body. Any type of infection can lead to sepsis. However, it is more often associated with lung, urinary tract, skin and abdominal infections.

In the last fiscal year, Delnor Hospital has seen a 10% increase in the total number of sepsis patients and a 33% increase in patients who arrived in severe sepsis, where there is already damage to the patient's organs.

"Early identification and treatment are key to improving sepsis outcomes. The sooner you begin antibiotics and fluids the lower the mortality," said Steven Coker, Jr., MD, medical director of emergency medicine and co-chair of the Sepsis Quality Committee at Northwestern Medicine Delnor Hospital.

The signs and symptoms of sepsis can include a combination of the following:

• high heart rate;

• low blood pressure;

• fever, or shivering, or feeling very cold;

• confusion or disorientation;

• shortness of breath;

• extreme pain or discomfort;

• clammy or sweaty skin.

Anyone can develop sepsis. However, patients who are at a higher risk include: adults ages 65 years or older; persons who are immunocompromised or have weakened immune systems; patients with chronic medical conditions such as diabetes, cancer, kidney disease, lung disease or heart disease; and patients who have recently had medical procedures performed.

In the last several years, Delnor Hospital has implemented sepsis-specific initiatives focused on more robust screening, evidence-based treatment, improved communication and education. Following these initiatives, severe sepsis and septic shock mortality decreased by 22%.

"We are identifying sepsis earlier by implementing an algorithm running in the background of our electronic medical record that alerts clinicians that sepsis is a possibility. We also obtain blood work earlier in the patient's course that would indicate a patient is septic," Dr. Coker said.

Once sepsis is identified, a core team of sepsis responders, including a Rapid Response Team, pharmacy, bedside nurses, respiratory therapy, and multidisciplinary providers, quickly initiate treatment. A checklist is used to ensure all treatment and monitoring elements are completed as indicated. The checklist and a handoff tool within the electronic medical record help to provide clear communication across departments.

"Delnor Hospital has met stringent government targets regarding sepsis for the past two years and as a result, we have made a palpable impact in the lives of our community," said Jonathan Y. Song, MD, vice president and chief medical officer, Northwestern Medicine Delnor Hospital. "Decreasing our sepsis mortality rate helped us achieve our second consecutive Bernard A. Birnbaum Quality and Accountability award from Vizient, an honor given to the top performing Complex Care Medical Centers in the United States."

To learn more about Northwestern Medicine, visit nm.org.

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