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VOL. 131 | NO. 186 | Friday, September 16, 2016

Public Awareness, Early Detection Most Important in Treating Sepsis

By Michael Waddell

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Annually it’s the third-leading killer worldwide behind only behind cancer and heart attacks.

More than 1.6 million Americans suffer from it each year and 258,000 of them die.

Hospitals spend more than $30 billion annually to treat it.

Yet few people have even heard of it.

It is sepsis, a deadly illness that is spawned by the body’s desperate response to infection which can lead to tissue damage, organ failure and death. It normally attacks the lungs, brain, urinary tract, skin and abdominal organs.

The infection moves around in a person’s bloodstream and will result in complete organ failure if not treated immediately with antibiotics and fluids. The likelihood of death increases by 8 percent every hour that treatment is delayed.

“The big challenge of sepsis or septic shock is to catch it early, because if you don’t it is usually fatal,” said Dr. Mark Miller, a surgeon with Methodist Healthcare.

But early detection is a problem when so few people are even aware that it exists. So nonprofits, hospitals and survivors have been making a concerted effort to raise awareness for several years.

Those efforts have culminated in September being named Sepsis Awareness Month. The first-ever Sepsis Congress took place online on Sept. 8-9. World Sepsis Day was Tuesday, Sept. 13. And New York City declared Sept. 15 Sepsis Day.

The Sepsis Alliance, one of the leading organizations in raising sepsis awareness, hosted its fifth annual Sepsis Heroes gala on Sept. 15 in New York, honoring people and organizations who have helped raise sepsis awareness.

“Our work centers around public education so we all know the signs and symptoms of sepsis and know to seek urgent medical attention if we believe we or a loved one may have sepsis,” said Thomas Heymann, executive director of Sepsis Alliance. “We also work with hundreds of hospitals to organize education initiatives to help raise awareness among health professionals.

“The key is to get the patient to treatment more quickly.”

Common signs and symptoms to look for include fever, increased heart rate, increased breathing rate, confusion, pneumonia-like conditions, or problems urinating from kidney issues.

Quick treatment saved Memphian Jim Howell’s life. Howell, whose wife is local public relations professional Amy Howell, went into septic shock in January 2015 a few days after having an elective, relatively routine surgery to remove a part of his colon.

Amy Howell was familiar with sepsis and suspected her husband was suffering from it. So she decided to transfer him to a different hospital, Methodist Healthcare.

“Methodist Healthcare has been a pioneer in early identification and intervention of severe sepsis,” said Methodist Le Bonheur Healthcare CEO Gary Shorb. “In 2007 Methodist designed an electronic sepsis alert that proved so successful it was later adopted by a major electronic health records provider for inclusion in their software and is now used by hospitals across the world.”

The combination of technology and clinical practice resulted in a 43 percent decrease in sepsis-related mortality over the past decade, helping an estimated 49 patients every month (nearly 600 a year) survive sepsis.

“Signs indicating a patient may have sepsis are minor and difficult to catch, so the sepsis alert looks for a collection of minor things that can point to a severe problem,” Miller said.

Methodist’s expertise saved her husband’s life, Amy Howell said. Still, he spent more than 100 days in the hospital and had five more surgeries.

His harrowing ordeal included four trips to the ICU, twice being put on a ventilator, having a tracheotomy, suffering a tear in his small bowel, having his kidneys shut down and requiring emergency dialysis, and having to wear a colostomy bag for 15 months.

“He’s recovering and hopefully will not suffer any long-term damage from the severe septic shock and the trauma that his body’s been through over the past 16 months,” she said.

And she was so inspired by her husband’s battle to overcome sepsis that she wrote the third book in her “High Gear” series: “Healing in High Gear, Surviving Sepsis: A Guide for Families, Patients, Caregivers and Healthcare Providers.”

“Amy’s book is an excellent educational tool about what you need to know about sepsis for families facing a similar situation or for any family facing a lengthy hospital stay,” said Shorb, who wrote the foreword for the book.

Books like Howell’s and groups like the Sepsis Alliance are helping turn the tide. Fifty-five percent of Americans today are aware of sepsis, up from only 19 percent in 2003, according to a recent Sepsis Alliance Awareness survey. And more than 25 million more adults now know about the condition this year compared to last year.

In addition to awareness, advocates are also pushing for stronger hospital protocols. New York and Illinois are the only two states with legislated sepsis protocols in the emergency room (although many hospitals maintain their own).

“Many other states including Ohio and Indiana and others are driving state-wide change through their state hospital associations,” Heymann said. “This will bring change from those who will be responsible for implementing the change.”

In Memphis, Methodist has implemented several protocols to help early diagnosis.

“Another step Methodist has taken to catch sepsis early is to initiate screening for sepsis as soon as patients walk through the emergency room door,” Miller said. “Based on the responses to a series of questions, several lab tests can be ordered to determine if a patient has sepsis. These protocols help us determine much faster if a patient has sepsis so we can initiate treatment sooner.”

And while the Sepsis Alliance continues to hold events to raise awareness – Sepsis Awareness 5k walks/runs, Spike Out Sepsis volleyball tournaments and many other community events – early detection and treatment remain a priority.

“We are focused on time to treatment,” Heymann said. “We have existing medical protocols that have proven to be effective and to reduce mortality by 50 percent or more.”

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