Sepsis

Speaker A: Welcome to the podcast the patient's voice. Does it matter? This is a place where your voice will always matter to me. Health care is complicated, so I wanted to create a space where we will discuss tips, hot topics, provide resources, have guest speakers who are experts in the healthcare industry or real patients sharing their patient experience in hopes to help you navigate any healthcare setting. I want to focus on you, the patient, and discuss issues that matter to you in an open and transparent way. I am your host, Krista Hughes, the founder and CEO, uh, of Hughes Advocacy, in which I am a board certified patient advocate. I have a passion for patience. Let's be the change together. So, welcome back, friends. In today's episode, we're going to talk about a very serious topic and that is sepsis. And I'm going to do the show a little different today. I'm going to start with, um, a, uh, what would you do? Segment. Then I'm going to transition into, well, let's now talk about it. And finally, I'm going to wrap up the show where I provide you, um, tips on how to make your voice matter in those situations. So let's get started. So as I said, sepsis is a huge problem and a big topic and it's all over the news. Um, for example, there was an 18 year old that got a UTI and died of sepsis. Um, a 41 year old that had a kidney stone, a, uh, kidney infection that, um, left to amputation of their legs. And just recently, actually it was this morning, there was a lady that had an infection and her limbs literally mummified. And that's the first time I've ever heard of that. But that's how serious sepsis is. So today I'm going to give you two what would you do scenarios. And like I said at the end, um, I'm going to give you tips on how you would handle each situation. So the first, imagine you go to the emergency room and you have a concern about a spot on your lower leg that's red and swollen. You have fever, delirium and shortness of breath. The ER diagnoses you with cellulitis and your treatment plan is to take an oral antibiotic and follow up with your primary care doctor. You ask the ER doctor if they think it could be sepsis. They explained that it is not sepsis as it doesn't, uh, meet the criteria. So what would you do? Now, the second example, your loved one is in the ICU and is on a vent. You notice that their white blood cell count is going up. And so is their temperature. You're worried about a vap, and a VAP is a ventilator associated pneumonia. So you express your concerns, but they just dismiss you. You demand to test for this infection, this ventilator associated pneumonia infection. They finally test for it 24 hours after you demanded it. You're worried that not only does your loved one have a vap, but you're aware that it can quickly turn into sepsis. Then they tell you it could take three days before they get the bacterial infection culture back. But, uh, they reassured you that don't worry your patient, your loved one, the patient does not have sepsis, so what would you do? Okay, so those were the scenarios and we'll wrap it up at the end of the show on. I'll tell you how you should handle situations like this, but let's just talk about it. What is sepsis? A lot of people think sepsis is an infection. Per the cdc, sepsis is the body's extreme response to an infection. It's a life threatening medical emergency. Sepsis happens when you, when an infection you already have triggers some kind of chain reaction in your body. Most cases of sepsis start before patient even goes to the hospital. Infections that lead to sepsis most often are in the lung. Remember I said a vap, which is ventilator associated pneumonia, lung, urinary tract, skin, or your gastrointestinal tract, otherwise known as your GI tract. Without timely treatment, sepsis can, I mean rapidly turn to tissue damage, organ failure, or death. Per the Sepsis Alliance. Sepsis is a life threatening emergency that happens when your body's response to an infection. It damages your vital, uh, organs and leads to death. In other words, it's your body's overactive and toxic response to an infection. Like strokes or a heart attack. Sepsis is a medical 911 emergency that needs to be rapidly diagnosed and treated. There are two types of sepsis. There's sepsis, and then sepsis can progress to severe sepsis. And that's when addition to the signs of sepsis, there's now signs of organ dysfunction, difficulty breathing, you barely are having any urine output. And there's a lot of mental, uh, changes in your mind or in your brain. And then it's the third, which is the worst is septic shock. And it's the most severe stage. And it's just when your blood pressure drops to dangerous levels. And these patients are usually treated in the icu. And many physicians call these kind of patients the sickest people in the hospital. Anybody can get an Infection, and almost any of them, any infection can lead to sepsis. At least 1.7 million adults in America develop sepsis. And at least 350,000 adults who develop sepsis die during their hospitalization. And 1 in 3 people who die in a hospital, they had sepsis during that hospitalization. Now think about those statistics. So what causes sepsis? Infections can put your, you or your loved one at risk for sepsis. When germs get into a person's body, they cause an infection. If you don't stop that infection, it can cause sepsis. Bacterial infections, and I think I mentioned this earlier, um, are the most common cause of sepsis, but you can also get it from viral infections, fungal infections, the flu. As a matter of fact, one of my clients, um, had sepsis and I was demanding the doctor to test for sepsis and um, instead of treating the patient, he actually asked me to give him a definition of what sepsis was. So I gave him the layperson's sepsis definition. And he actually, instead of, like I said, treating this patient who eventually did have sepsis, he told me I didn't have my definition correct. And before I ever asked him to test for sepsis, I better know the definition. You do not ever need to be treated like this, ever, especially with a life threatening infection. So, um, I just wanted to plug that in there because it's very frustrating the way people are treated in health care. Now back on topic. Most people who develop sepsis have at least one underlying condition. Like, you know, we said it could be in your lungs if you have a chronic lung condition or obviously a weakened immune system system. Now listen to this. Nearly a quarter to a third of people with sepsis had a health care visit in the week before they were hospitalized. Now let that sink in. So who's at risk? Anybody can develop sepsis, but of course, some people are at higher risk. Adults over 65, um, like I said, people with compromised, um, immune system. If you have any chronic conditions like cancer, diabetes, diabetes, kidney disease, or if you've been recently sick or hospitalized. Now people can survive sepsis and some of the symptoms include, and they kind of mask some of the symptoms of like a uti, urinary tract infection. That's where sometimes the confusion is brought in. That's why I always just demand them to check anyway. But some of the symptoms could be fever, confusion, slurred speech, a rapid heart rate, shortness of breath, a rash, have not urinated in 12 hours or longer, or you have a lot of, um, muscle pain. So what do you do? If you think you have sepsis, it is a 911 emergency, and you need to get to the emergency room immediately, as fast as you can. And when you get there, you need to tell them, I believe I have sepsis, and I want to be tested for it right now. Because the faster you get, um, a diagnosis and treatment, most people survive. So the treatment that comes with it is usually just urgent care. And, um, you could be in the ICU or, um, they want to monitor your organs, vital organs, make sure it doesn't turn into severe sepsis or septic shock. And, you know, they can treat it with, like, sometimes IV medication. And it's usually diagnosed by a blood culture, white blood cell count, temperature, and, um, per Johns Hopkins. Treatment for sepsis requires prompt intravenous treatment with a broad spectrum IV antibiotic. But the original source of the infection must be identified and, and then treated with the appropriate antibiotics. So what they mean is when they say the original source of the infection, remember, uh, a minute ago I said that sepsis is usually a bacterial infection, but it can also be a fungal or a viral infection. So it's important for them to find out, excuse me. What kind of, um, infection you have to better treat for sepsis. So now that we've kind of, kind of talked about it, told you a little bit about, um, sepsis, I'm going to talk about some tips on how to make your voice matter in the scenarios I, uh, talked about at the beginning in the what would you do? Segment. So remember the scenario with the patient and the ER diagnosed with cellulitis. Remember, we learned that sepsis is a response to an infection and you need to act fast. The ED doctor or, uh, emergency room doctor told us that the patient did not meet criteria. However, we still wanted the patient to be tested. They denied us three times. After the third time, I demanded it, and we still got pushback, but the facility was finally gave in, uh, to our demand, and this patient, in fact, had sepsis. If I had not demanded that, this client would have gone undiagnosed. It could have been fatal. And that's a shame. The second example with the client that was on the vent, this facility continued to refuse testing. They would not give us access to the patient's medical records, and they were covering up information, denying care that we demanded. And because of all of this, this patient died due to this unnecessary death. We even reported this to CMS Joint Commission. the state level, this death by this patient was 100% preventable. The doctors knew he had Sepsis, the C suite nurses and they did absolutely nothing. Unfortunately, in today's health care landscape, you have to fight for your loved ones in the hospital. You cannot trust the health care system. Do not let your family member be a statistic. Now here are some interesting questions that I just wanted to read off because I thought they were interesting, um, to think about. And they came from the cdc and one is I have an infection that doesn't seem to be getting any better. I'm concerned this could be leading to sepsis. What can I do to make sure this does not happen? These are great questions to have with your health care team. My six month old son had a low grade fever and cough yesterday. But today he's not alert. He's making fewer wet diapers and is having difficulty breathing. Could this be leading to sepsis? And the last one, my grandmother has a urinary tract infection. She's had a fever for the past few days. She's also been confused and disoriented. Could her infection be leading to sepsis? As always, all the resources that I talked about today in um, this episode, they're available in the show Notes. And um, I just appreciate y' all listening um, to this podcast because at the end of the day this podcast is for you because I want your um, voice to matter. If you enjoyed the show, make sure you share like follow, review me on Apple Podcasts, Spotify and Google Podcast. Also, you can watch this via my YouTube channel. And please reach out to me if you or your loved ones need any help in navigating the healthcare system. So be sure to come back next time because I'm going to talk about a discussion on what do you do if you get a cancer misdiagnosis. Until then, this is Christa Hughes. I have a passion for patience. Let's be the change together. Sam m. Mhm.