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Doctors encouraged to heed NICE guidelines on sepsis

Posted: 04/10/2016

Recent guidance from the National Institute of Health and Care Excellence (NICE) follows long-standing concerns that sepsis is often diagnosed too late and opportunities to treat it are missed because of a lack of alertness to the signs and symptoms. The impact of sepsis can be devastating, even fatal. It is estimated to cause over 40,000 deaths a year in the UK and NICE is urging doctors to be more vigilant.

Sepsis is a difficult condition, caused when the immune system recognises and fights bacterial infection, but does so excessively and damages the body itself. This can occur anywhere in the body and can be life-threatening if vital organs are affected. Many different bacteria have the potential to cause infection and sepsis. Those who are unwell, elderly or very young are most at risk.

Early warning signs are similar to flu-like symptoms, with fever and very high (or low) body temperature, fast heart rate and shivering. This can make sepsis difficult to distinguish from other conditions in its early stages, but it is important for doctors to be alert to the possibility.

As sepsis takes hold it can cause the patient to become delirious, with extreme pain, shortness of breath and diarrhoea and vomiting, by which time damage is already being caused. Early treatment with antibiotics, either oral or intravenous, can treat sepsis very successfully, but if diagnosis or treatment is delayed, permanent damage can be caused.

Andrew Clayton of Penningtons Manches' clinical negligence team welcomes the latest NICE guidelines and comments: "These are an important step in raising awareness of sepsis. Doctors already take seriously the potentially catastrophic risk, but the number of deaths from sepsis in the UK remains high and it is widely believed that many of these could be avoided. The same is likely to be true of patients who survive, but suffer long-term damage as a result of sepsis. 

"We are often asked to advise patients on the standard of care they have received in relation to treating infection. As an example, I am currently acting for a girl who had secondary infection following chicken pox that led to septic shock. She consulted two GPs, was the subject of a telephone call to the out-of-hours service and visited A&E twice before sepsis was diagnosed. By then, she was losing consciousness, went into toxic shock and suffered permanent injuries. Expert evidence is that this could have been avoided had doctors been alert to the signs and acted earlier with simple antibiotic therapy. 

"Encouraging doctors to watch for the warning signs of sepsis and to listen to patients to be vigilant to the possibility are key to making sure proper treatment is delivered before it is too late."

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