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Could it be sepsis? The first national standard of care for sepsis patients

1 Aug 2022

The first national standard of care for sepsis patients has been released in Australia, aiming to improve the recognition, treatment and management of the condition which is the body’s life-threatening response to infection, causing damage to its own tissues and organs, potentially leading to death.

We want our clin­i­cians to think about sep­sis all the time – even though it’s some­thing they won’t see all the time,” says Dr Lor­raine Ander­son, Med­ical Direc­tor at the Kim­ber­ley Abo­rig­i­nal Med­ical Ser­vices in West­ern Australia.

Lor­raine, who has worked in the Pil­bara, Indi­an Ocean Ter­ri­to­ries and now the Kim­ber­ley for 15 years, wel­comes the new Sep­sis Clin­i­cal Care Stan­dard released by the Aus­tralian Com­mis­sion on Safe­ty and Qual­i­ty in Health Care on 30 June 2022, which will be imple­ment­ed by health care ser­vices nation­al­ly to improve sep­sis recog­ni­tion and outcomes.

Man­ag­ing patients in a remote com­mu­ni­ty is high stakes,” Lor­raine says. With sep­sis, we don’t have a minute to waste, and that’s par­tic­u­lar­ly so in remote com­mu­ni­ties which might be 1,000km away from the near­est major hospital.”

Patient trans­port vehi­cle in the Kimberley.

The impact of sepsis

Many peo­ple have nev­er heard of sep­sis, but it kills more Aus­tralians annu­al­ly than road traf­fic acci­dents or stroke. Every year, over 55,000 Aus­tralians are diag­nosed with sep­sis and more than 8,700 will lose their lives to the con­di­tion. Oth­ers end up liv­ing with ampu­ta­tions and post-sep­sis syn­drome. Annu­al­ly, it results in $700 mil­lion of direct hos­pi­tal costs, and $4 bil­lion in indi­rect costs.

Spot­ting the signs can be tricky, as they can over­lap with oth­er con­di­tions. Sep­sis can arise with any infec­tion, the most com­mon being res­pi­ra­to­ry, gas­troin­testi­nal and uri­nary. For some peo­ple, sep­sis starts with an infec­tion that gets worse instead of bet­ter. Ear­ly treat­ment (typ­i­cal­ly with intra­venous antibi­otics) can reduce the risk of death or seri­ous complications.

Aware­ness of the exis­tence of sep­sis in the com­mu­ni­ty is low, and rais­ing aware­ness is one of the aims of the new standard.

In 2020, 41 per cent of Aus­tralian adults had nev­er heard of sep­sis with peo­ple in the 18-to-34-year-old age group, who are most like­ly to have young chil­dren, hav­ing low­er aware­ness than the over-50s.

Any­one can get sep­sis, but young chil­dren, old­er peo­ple, Abo­rig­i­nal and Tor­res Strait Islander peo­ples, peo­ple liv­ing in remote com­mu­ni­ties, and peo­ple liv­ing with can­cer or immuno­sup­pres­sion are dis­pro­por­tion­ate­ly affect­ed. Glob­al­ly, more than 50 per cent of sep­sis cas­es are in chil­dren and ado­les­cents. Old­er peo­ple who get sep­sis have high mor­tal­i­ty rates of 50 to 60 per cent.

Ask­ing the question

The chal­lenge of diag­nos­ing and man­ag­ing sep­sis is com­pound­ed in Abo­rig­i­nal and Tor­res Strait Islander com­mu­ni­ties, says Dr Ander­son, where patients often have com­plex con­di­tions and comor­bidi­ties, such as heart dis­ease, dia­betes or kid­ney disease.

The advan­tage, how­ev­er, in remote area pri­ma­ry care clin­ics is that we are con­nect­ed with local com­mu­ni­ties and have rela­tion­ships with our patients and their fam­i­lies,” she says. 

We lis­ten when the fam­i­ly says, we’re real­ly wor­ried’. It’s dif­fer­ent to a big emer­gency depart­ment where the clin­i­cian doesn’t know the per­son they’re deal­ing with.

If some­one is sus­pect­ed of hav­ing sep­sis in a remote clin­ic, the health care work­er needs to act quick­ly and call the doc­tor – who may be off-site – and say it could be sepsis.

Just say­ing this could be sep­sis’ will set things in motion for assess­ment, treat­ment and pos­si­ble evacuation.”

For the gen­er­al pub­lic, pre­vent­ing infec­tion can help pre­vent sep­sis, and rec­om­men­da­tions include:

  • Get­ting vac­ci­nat­ed against the flu and oth­er poten­tial infections
  • Ensur­ing wounds are treat­ed appropriately
  • Prac­tis­ing good hygiene by wash­ing hands and reg­u­lar bathing.

Patient han­dover on the tar­mac at Bal­go Airport.

Click here to read the full Sep­sis Clin­i­cal Care Stan­dard.