Sepsis is a serious medical condition caused by a poorly regulated immune response to infection. It is comprised of a complex chain of events including inflammatory and anti-inflammatory processes, humoral and cellular reactions, and circulatory abnormalities. This may result in impaired blood flow, which damages organs by depriving them of nutrients and oxygen.
Symptoms of Sepsis
Sepsis can begin in different parts of the body and can have many different symptoms. In many cases, the first symptoms can include rapid breathing and change in mental status or confusion.
Additional symptoms include:
- Change in body temperature (fever or chills)
- Rapid pulse
- Nausea and vomiting
In some cases, sepsis includes symptoms such as diarrhea and changes in volume of urination.
Did you know?
- Mortality from sepsis increases 8% for every hour that treatment is delayed.1
- As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment.1
The Surviving Sepsis Bundle2 suggests that serum lactate must be available with rapid turnaround time—within minutes—to effectively treat severely septic patients. An arterial blood gas analyzer located in the clinical laboratory usually accomplishes this. But, if a central analyzer is not efficient in a particular hospital setting, point-of-care analyzers may be evaluated for faster turnaround time.
In Dora’s case, the emergency responders were able to share symptoms with the hospital ahead of time, and the clinician recommended running blood gas with a basic metabolic panel with lactate. They could do this with the epoc® Blood Analysis System, and report results back to the hospital before arriving so that hospital staff could prepare to treat her.
Lactate Measurement is Step One in the Sepsis Resuscitation Bundle
The Sepsis Resuscitation Bundle2 is published by the Surviving Sepsis Campaign and is used by multiple hospitals across the United States. The goal is to perform all indicated tasks and evidence-based objectives 100% of the time within the first 6 hours of identification of severe sepsis.
The Resuscitation Bundle includes five tasks:
- Measure lactate level.*
- Obtain blood cultures before administering antibiotics.
- Administer broad-spectrum antibiotics.
- Begin rapid administration of 30ml/kg crystalloid for hypotension or lactate ≥4 mmol/L.
- Apply vasopressors if hypotensive during or after fluid resuscitation to maintain a mean arterial pressure ≥ 65 mm Hg.
This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.
* Remeasure lactate if initial lactate elevated (> 2mmol/L).
1. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Kumar A, et al. June 2006. https://www.ncbi.nlm.nih.gov/pubmed/16625125
2. SSC Hour-1 Bundle. Surviving Sepsis Campaign. http://www.survivingsepsis.org/Bundles/Pages/default.aspx