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Could it be sepsis? The first national standard of care for sepsis patients
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.”
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.
Click here to read the full Sepsis Clinical Care Standard.