Sepsis is a condition caused by your body’s immune system responding abnormally to an infection, which can lead to tissue damage, organ failure, and death. The infection can start anywhere in your body; it may be only in one part, or it may be widespread. Your immune system usually works to fight any germs (bacteria, viruses, fungi), or to prevent infection. However, for reasons we don’t fully understand, sometimes the immune system goes into overdrive and starts to attack our organs and other tissues. Common infections leading to sepsis include the following (we’ve put the words that healthcare professionals use in brackets):

1. chest infections (pneumonia)
2. urine infections (urinary tract infection)
3. leaks from the bowel (intra-abdominal sepsis)
4. infections of skin (cellulitis), joint (septic arthritis) and bone (osteomyelitis)
5. infection of the blood (bacteremia) or heart (endocarditis)

Sepsis is not a mild illness. People with sepsis usually feel extremely unwell with one or more of the following symptoms:

1. Slurred speech or confusion
2. Extreme shivering or muscle pain
3. Passing no urine (for a day)
4. Severe breathlessness
5. It feels like you are going to die
6. Skin mottled or discoloured

If someone you care for is sick with an infection and/or fever, ask yourself:

1. are they confused or difficult to wake?
2. are they breathing very fast?
3. do their hands and feet feel cold or do they have mottled skin?
4. have they stopped passing urine (for a day)?
5. are they sicker than they’ve ever been before?

If yes, call 111 and tell the operator and ambulance crew that you’re worried about sepsis

In other circumstances it may be appropriate to see your GP or urgent care provider and “just ask – could it be sepsis?/ he pātai – he sepsis tēnei?

Sepsis can affect anyone, but some people are more at risk than others:

1. The very young and very old
2. People with diabetes
3. People with weak immune systems (due to chemotherapy or drugs like prednisone)
4. People who have had an organ transplant
5. People with long term medical conditions like liver, heart and kidney disease
6. People who are pregnant or who have just given birth

In New Zealand, sepsis (and the infections that lead to sepsis) are more common amongst Māori and Pacific people than non-Maori, non-Pacific people.

Many people who get over the initial infection still need a lot of help with:

1. Regaining physical and mental strength
2. Completing a course of antibiotic treatment
3. Assessing the reason that the infection happened in the first place i.e its underlying cause
4. Making sure that the home environment is safe for people leaving hospital with new physical disability

This process of recovery and rehabilitation often requires an average length of stay in hospital of seven days. 

People who leave hospital after sepsis often struggle to return to their previous level of function. The main problems directly related to sepsis are physical, cognitive (relating to brain function) and psychological.

There is no easy way to deal with these problems and nobody is the same – in some cases people barely notice any change, in others the effects of sepsis can be devastating, costing people their independence and/or livelihoods. On a positive note, symptoms usually improve over time and can respond to therapy. Speak with your healthcare professional about recovery from a severe illness, and ask for extra help if you need it.

It may also help you to do the following:

1. Speak with friends and relatives about what you’re feeling and going through
2. Keep a diary during your recovery, so that you can see where things have improved
3. Get in touch with your GP once you’ve left hospital and explain how things have been at home
4. Speak with your employer about a graduated return to work if that is available to you – remember, sepsis is a severe illness like a heart attack or stroke and many people with these conditions can’t go straight back to work

There has been some research into sepsis survivors which found that, over the following year at least, some survivors are more prone to contracting another infection. As with any infection, there is a risk of sepsis. But most people who’ve had sepsis before seek help early on and are treated promptly.

If you (or your loved one) have an infection, then you should keep a close eye for any signs of sepsis and seek help urgently if worried.

1. A healthcare worker will see signs of an infection and one or more of the following:
2. A very low blood pressure
3. A very fast heart rate
4. Rapid breathing (25 breaths per minute or more)
5. Low levels of oxygen in the blood
6. A reduced level of consciousness (somebody responding only to voice or pain)
7. High levels of lactic acid in the blood (indicating the body isn’t getting enough oxygen)

It is very important to give treatment for sepsis as early as possible. This is why recognising the symptoms of sepsis and calling for help is so important.

After sepsis has been recognised there are six things that have to be done within one hour – this is called the ‘Sepsis Six bundle’. In healthcare, a ‘bundle’ is a group of interventions which reduce harm (or improve outcomes) when given together as a package. If everything in the Sepsis Six is done within an hour (compared with no treatment), the chance of death from sepsis is roughly halved.

The Sepsis Six steps are:

1. Give antibiotics
2. Give fluids
3. Give oxygen (if required)
4. Take blood cultures (to try and grow the bug causing sepsis)
5. Take a blood lactic acid level (a ‘lactate’)
6. Take measurements of urine output (to make sure enough blood is flowing to the kidneys)