Sepsis is extremely common and accounts for as many deaths as heart attack each year. Recently published guidelines summarise the most up-to-date method of caring for these patients, giving hope for improved recovery.
More than 100,000 people are admitted to an intensive care unit (ICU) somewhere in Australia each year. For around one in five of these patients (20,000 people), the main reason for their admission is sepsis, and more than 20% (about 4,000 people) of them won’t survive to go home.
Sepsis, also known as septicaemia, is a whole body infection. It’s usually caused by an infection in one part of the body, such as a wound or in the lungs, that spreads. Sepsis causes dysfunction of organs, causing respiratory failure, heart failure or kidney failure. It often affects more than one organ.
Treatment requires support of the dysfunctional organ, for instance, by connecting the patient to a ventilator or breathing machine to support dysfunctional lungs or giving drugs to support the heart and increase the blood pressure. Such treatment is provided in intensive care units.
Caring for patients with sepsis is challenging and requires the nursing and medical clinicians to be up-to-date with many different aspects of care. Naturally, providing the best possible care increases the chance that patients will survive and recover to go home.
Several international groups have been established to help improve the understanding of sepsis and the most appropriate care for patients. These include the Global Sepsis Alliance and the Surviving Sepsis Campaign.
The Surviving Sepsis Campaign Guidelines, first published in 2004 and updated in 2008, provide one avenue to help clinicians be up-to-date with the latest evidence in this area of care. Unfortunately the guidelines only summarise the evidence for the medical care of septic patients.
Nurses are the primary carers of patients in intensive care units. As such, they make many of the decisions and provide most of the care given to people with sepsis. So a companion document that summarises the evidence for the nursing care of such patients has now been published.
This paper, Nursing considerations to complement the Surviving Sepsis Campaign guidelines, was published in the international journal Critical Care Medicine in July 2011. Thirteen authors from across the world reviewed more than 250 publications of individual research studies to provide a summary of the most up-to-date and appropriate nursing care for people with sepsis.
Important aspects of caring for such patients include infection prevention and management, initial resuscitation, haemodynamic support and other supportive nursing care. There are also specific considerations for paediatric patients with sepsis. Each of these areas of care has been addressed separately in the paper.
In preparing this review the authors appraised and focused on high quality research. As a result, nurses in intensive care units are able to quickly refer to one comprehensive paper to guide their care rather than having to locate, review and appraise many individual papers.
Like so many areas of intensive care, there are many aspects of caring for people with sepsis where we would benefit from more research. These papers help by summarising the best research that we have available. Hopefully, this means that some of the 4,000 people who die because of sepsis every year in Australia will be able to recover and go home instead.
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