Septic shock is characterised by a sharp drop in blood pressure after an infection to critically low levels. Sepsis, the precursor of septic shock, is a potentially life-threatening condition that arises when the body’s response to infection triggers a cascade of changes that can damage multiple organ systems leading to dysfunction. Undetected and untreated sepsis can develop into septic shock, a medical emergency requiring immediate treatment.
Sepsis Cases in Queensland Australia
The Australian Sepsis Network identifies sepsis as a major cause of morbidity and mortality on a global scale. With a 0.77/1000 incidence from the adult population receiving treatment in intensive care units (ICUs), there are about 15,700 new cases every year with 5,000 deaths. From 2019 to 2020 in Queensland, 2,000 ICU patients died of sepsis out of the 21,000 people admitted to public hospitals.
From Sepsis to Septic Shock
Sepsis can be described as the initial response of the body to infection entering the bloodstream that can progress to severe sepsis and septic shock if not diagnosed early. Once the infection worsens, the body’s immune systems go into overdrive.
Sepsis
The body normally releases chemicals into the bloodstream to fight infection. Sepsis occurs when the body’s response to these chemicals is out of balance.
Severe Sepsis
The degree of infection is widespread. Blood vessels break due to toxins produced by bacteria causing the infection, inflammation worsens and organ functions are disrupted.
Septic Shock
What is septic shock? Blood pressure drops drastically brought about by severe infection. The heart has difficulty pumping clean and oxygenated blood throughout the body resulting in organs shutting down. This can lead to death without emergency care or intervention.
Who are at Risk of Septic Shock?
Sepsis can occur in people of any age. People with weakened immune systems or chronic medical conditions are at greater risk for sepsis. This is commonly seen in newborn babies or infants, children, older adults and pregnant women.
There are many potential causes of septic shock, but the most common is infection – bacterial in nature, rarely fungal or viral. Infections can occur anywhere in the body but are most often found in the lungs, urinary tract, or gut. When these infections are left untreated and spread throughout the bloodstream, they can cause septic shock. Here’s a list of medical conditions susceptible to sepsis that would likely result in septic shock if not monitored.
- Patient recovering from surgery
- People admitted to the hospital for a long time
- People with existing long-term health conditions affecting the major organs
- People with lowered or suppressed immune systems e.g. HIV infected and cancer patients undergoing chemotherapy
- People taking immunosuppressant drugs
- People living with diabetes
- Those receiving treatment with regular or continuous insertion to the body that can harbour bacterial growth e.g. IVs and catheters
- Those in long-term use of antibiotics
- Those in recent or current use of steroid medicines
- Patients who had an organ or bone marrow transplantation
First aid training and certification are extremely useful in emergency cases such as shock. CPR First Aid offers nationally accredited courses in different locations in Queensland including Southport. Know more about shock first aid in Southport here.
What are the Symptoms to Watch?
It’s important to detect sepsis early on in order to prevent it from progressing into septic shock.
Sepsis Symptoms
At first, this can be hard to diagnose, symptoms can be similar to catching a cold or having the flu. This can be one or a combination of the following that persists longer even after taking medications.
- Fever and chills
- Shortness of breath
- Elevated heart rate
- Confusion or disorientation
- Sweaty or clammy palms and skin
- Confusion or disorientation
Septic Shock Symptoms
The condition is severe. Toxins produced from the infection break blood vessels and organs fail to function properly. Symptoms of septic shock include:
- Low blood pressure especially when the person stands up
Clinical signs of progression: The patient needs to be given medication to maintain systolic blood pressure greater than or equal to 65 mmHg - A fever above 38.5°C
- Chills and/or rigours (shivering uncontrollably)
- A heart rate of more than 90 beats per minute
- Respiratory rate of more than 20 breaths per minute
- Inability to urinate in the last 12 hours
- Extreme pain or a general feeling of discomfort
- Change in mental status – confusion or disorientation
Evaluation and Treatment
The goal of septic shock treatment is to save lives and reduce complications. Treatment focuses on identifying and treating the infection, as well as supporting the organ systems that are affected by sepsis. With early diagnosis and aggressive treatment, septic shock can be managed effectively.
When to See a Doctor?
In most cases, sepsis occurs when a patient has been hospitalised for too long or is recovering from a recent surgery. Sepsis can progress to septic shock within half a day. If you think you or someone you know is experiencing any of the above-mentioned symptoms, seek medical help immediately.
What are the Diagnostic Tests for Septic Shock?
The doctor may request several tests to identify the causative agent of the infection that led to sepsis, how far along the infection is, the extent of organ damage, and/or any additional bacterial infections. These tests will usually be carried out.
Blood tests
To check for infection, inflammation and organ damage.
Imaging tests
X-rays, ultrasound or computed tomography (CT) scans, to look for signs of infection or inflammation
Cultures
To identify the bacteria or other organisms causing the infection
Biomarkers
To measure levels of substances in the blood that may be indicative of septic shock. One of the markers checked is high levels of lactic acid in your blood, serum lactate. This is due to cells not utilising oxygen properly.
Echocardiography
To assess heart function and look for signs of fluid in the lungs
Common Treatments for Septic Shock
Infection must be eradicated with antibiotics and organ damage reversed. Surgery may be needed to remove the source of infection and infected tissues or drain a pus-filled abscess. Intravenous (IV) fluids will have to be administered in large amounts to treat dehydration. Below are the common treatments and management given to the patient.
- Antibiotics: to fight the infectionÂ
- Fluids and electrolytes: to replace fluids that are lost due to sepsisÂ
- Oxygen: to support breathingÂ
- Vasopressors: to help stabilise blood pressureÂ
- Nutrition: to help the body healÂ
- Surgery: to remove infected tissue
- Corticosteroids: to reduce inflammationÂ
- Dialysis: to support kidney function
Full recovery will depend on:
- the person’s age
- the extent of infection and organ damage
- how soon treatment was introduced
- other illnesses present.
It is noteworthy that the sooner sepsis is diagnosed and treated, the faster a person recovers.
How Can First Aid Help?
Shock is a critical condition requiring emergency medical care. First aid for shock in Southport is taught by fully qualified and experienced trainers. If you’re interested in availing of a basic first aid course in Southport, reach out to us and we’ll be happy to accommodate your questions.
