Hospitals in New Hampshire and Vermont are making progress in the battle against a leading cause of death. Sepsis is triggered by infection and causes inflammation through the entire body. But Emergency Departments are now intervening quickly to save lives.
Nationally, sepsis strikes about a million people annually, and treatment costs an estimated $20 billion. Because the condition mimics other diseases, proper diagnosis and treatment can come too late. So between 25 and 50 percent of patients die in the hospital. But many hospitals now test blood immediately for sepsis, and give intravenous fluids and antibiotic treatment within three hours of admission.
Earlier this fall, those timely steps probably saved Kathy Gaudette’s life at Dartmouth Hitchcock Medical Center’s Intermediate Special Care Unit.
“I wouldn’t be here today if it wasn’t for what they did. I really didn’t realize how sick I actually was until I was in my bed in the SCU and the doctor told me, ‘You are a very, very sick lady and we are going to everything we can.’ And I saw my husband look at the doctor and he squeezed my hand, and that was pretty frightening, it really was,” Gaudette recalled.
Her illness started with a simple infection. But if Gaudette had entered Dartmouth-Hitchcock six months ago, chances are she would not have survived. Back then, Dr. Andreas Taenzer says, about a quarter of the patients who arrived with sepsis died in the hospital. Of those who develop septic shock, which is sepsis plus low pressure, 40 percent die.
Those are higher rates than from heart attack or stroke.
“But what makes it a little bit different from stroke or heart attack is that it could hit anybody,” Taenzer noted. “It could be a healthy 16-year-old teenager being bitten by a spider in the backyard who develops sepsis in that fashion. So it truly can hit anyone any time, anywhere, really.”
"But what makes it a little bit different from stroke or heart attack is that it could hit anybody. It could be a healthy 16-year-old teenager being bitten by a spider in the backyard who develops sepsis in that fashion. So it truly can hit anyone any time, anywhere, really." - Dr. Andreas Taenzer, Dartmouth-Hitchcock Medical Center
Sepsis symptoms include elevated breathing and heart rates, confusion, fever, chills, and nausea. Amy Curley says she and other Dartmouth-Hitchock nurses now make low-tech, split-second decisions, touching patients, eyeing them, estimating heart and breathing rates, before ordering diagnostic blood tests.
"So it is very basic but important nursing skills and they do require some teaching of what we are looking for ..." - Amy Curley, nurse at Darmouth-Hitchcock Medical Center
“So it is very basic but important nursing skills and they do require some teaching of what we are looking for – but really basic nursing skills that I am really glad to see us getting back to,” Curley said.
It took some time to get all staffers at the hospital to use the new protocols. In fact, the compliance rate at first was only five percent. But after reviewing that data, medical teams got much better at detecting and treating the deadly infection. So in six months the death rate from sepsis has been cut in half at Dartmouth Hitchcock.
George Blike, a physician and chief quality control and value officer, says the Medical Center is teaching the interventions to other hospitals so that patients do not arrive on its doorstep too sick to save.
“And ... in this science of health care delivery — this is huge,” he said.
Anti-sepsis protocols are also in use at the University of Vermont Medical Center.
