“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.