26 Sep 2018
By rick.craven
Tags: 
sepsis
Dental

We have all become increasingly aware of the term Sepsis in the last year or so as more and more cases of Sepsis, and Septic Shock come to light.

The CQC has published a mythbuster on the topic and expect Dental Care Professionals to have an understanding of what Sepsis is, what the signs and symptoms of Sepsis are, and a protocol for patients who present with signs of Sepsis to refer on to other care providers.

CQC mythbuster 25: Sepsis click here >

Sepsis can occur when acquiring an injury or when infection develops in the body, it is a misconception that you only get Sepsis in hospital, in fact, only 30% of cases of Sepsis develop from admittance into a hospital, the remaining 70% are from the community.

Sepsis can develop in the mouth, although rare, following extractions, from an abscess or root canal treatment. Sepsis is your body's overreaction to infection when the chemicals your immune system releases to fight the infection cause inflammation in the body and attack your organs instead of fighting the infection. This can result in life-changing challenges or even death.

Sepsis is responsible for approximately 46,000 deaths each year in the UK, this is more than Bowel, Prostate and Breast Cancer put together.

Sepsis can present itself to look a lot like Flu, a chest infection, Meningitis, or Gastroenteritis and can often be misdiagnosed - signs and symptoms are different for adults and children which we will go through below.

 Signs of Sepsis in Adults

  • Either a fever-like temperature or a low body temperature 
  • Chills and shivering (even with a fever)
  • Raised heart rate
  • Fast breathing

Signs of Sepsis in Children

  • Mottled, bluish, or pale skin
  • Lethargic or difficult to wake up
  • Cold to touch
  • Rapid breathing or breathing that pauses
  • Has a rash that doesn’t blanch
  • Has a fit or convulsion

Signs of Sepsis in Babies

  • The soft spot is bulging
  • No interest in feeding 
  • No wet nappy for 12 hours
  • Sunken eyes
  • Baby is floppy

If any of the above signs and symptoms flag then the individual must go to A&E or call 999 immediately, it is imperative that Sepsis is treated without delay to increase chances of survival, as without quick treatment multiple organ failure and Septic Shock can ensue and cause death.

Septic Shock

If Sepsis is not treated quickly, a more severe case of Sepsis can develop into Septic Shock - signs of a person developing Septic Shock are:

  • Feeling dizzy or faint
  • Confusion or disorientation
  • Diarrhoea
  • Slurred speech
  • Vomiting
  • Muscular pain
  • Not urinating for 18 hours
  • Breathlessness (severe)
  • Loss of consciousness 
  • Mottled skin

Again, if any of the above symptoms flag call 999 immediately or go straight to A&E.

Hospitals use toolkits to assess the severity of Sepsis and will treat a patient very quickly. Patients can make a full recovery in a short amount of time depending on the severity and the treatment that was undertaken after diagnosis, as well as their general overall health before Sepsis was diagnosed. 

Some people will experience Post Sepsis Syndrome following treatment of Sepsis. Symptoms of this include:

  • Feeling excessively tired
  • Feeling weak 
  • Breathlessness
  • Chest pain
  • Swollen limbs
  • Swollen joints

Post Sepsis Syndrome can sometimes last longer than 18 months, although this is rare.

Who is at risk?

Anyone young or old can develop Sepsis following an injury or minor infection, although people who are most at risk of developing Sepsis are:

  1. People who receive medical treatment that weakens their immune system (such as Chemotherapy)
  2. The very young or the very old
  3. People who have wounds or injuries following an accident
  4. People with serious illnesses that are in hospital
  5. Someone who has developed Pneumonia
  6. Pregnant women 
  7. People who have drips or catheters attached to the skin
  8. Diabetic
  9. People who have a medical condition that weakens their immunity (such as HIV or Leukaemia)

Approximately 250,000 cases of Sepsis are diagnosed every year in the UK (as per the UK Sepsis Trust) and this amount is increasing.

We can establish that Sepsis is a life-threatening condition, and we must ensure all practices are aware of the signs and symptoms and how to deal with patients and or staff members that present with these symptoms.

Practices should carry out a team meeting and set a clear, time effective protocol to follow and have quick reference guides that they can use to identify possible cases. There are some resources available on the UK Sepsis Trust website under professional resources that are appropriate for use in dental practices.

Sepsis Trust website click here >

Comments

Very helpful

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