Have you ever been told a really scary story by someone you care about?
And they thought it was quite funny and you just had images of them careering over the edge of a cliff?
I had this experience not so long ago.
My young, lovely family member told me with a smile how she'd ignored the symptoms of a urine infection until it turned into lower back pain.
Not one to make a fuss, she had vomiting, shaking, a temperature and muscle aches - and thought she'd just 'sleep it off'.
It's scary to think about what might have happened if her partner hadn't found her and insisted on taking her into A and E, scooping her off the sofa in her slippers and dressing gown.
And the way she told the story, she thought it was kind of funny, like oh well, we all hallucinate from a bad infection from time to time!
Sepsis is relatively rare, but it still kills more people than breast and bowel cancer combined. I'm not scaremongering - most pregnant and postnatal women are healthy and will never get sepsis.
But to save lives, it's still really important everyone knows what to look for, which is why I wanted to put together this post.
6 Quick Sepsis Facts
1. It Hasn't Caught The Attention Of The Public Yet
This is probably because it's difficult to spot, symptoms are diverse and rapid.
In fact, healthcare professionals struggle to spot it as well, it can be subtle.
But to reduce mums and babies dying (and lots of other patients too), public awareness needs to be raised.
2. It's Difficult To Stop Once It Takes Hold
I think my family member thought that even if she got really ill and went into hospital, IV antibiotics, fluids and painkillers would patch her up fast.
But the harsh truth is even if you're young and healthy, the body goes into immune response overdrive when sepsis occurs.
There's a limit to what medicine can do.
If an infection goes too far, your organs start to fail and the way your blood coagulates changes - which can cause clots and death from the complications.
3. Care Can Be Improved
In 2015, only 1/3 of patients with sepsis got 'good quality' care.
MBBRACE says that if pregnant/postnatal women self-refer feeling ill a few times, they should be taken very seriously. There are challenges in the NHS at the moment, but even slight abnormalities in observations should make you 'Think Sepsis'.
There’s been something launched called the ‘Sepsis Six’, which is about the emergency procedures for any patient who comes in with sepsis, see here.
Midwives and other frontline maternity staff have reduced genital tract sepsis by half since 2010, for which they deserve a great deal of praise!
The efforts of those staff can't be thanked enough: it means more mums and babies get to live.
4. Pregnancy Makes Things More Serious
EVERYONE with sepsis needs to get their antibiotics within an hour of diagnosis – this is known as the ‘Golden Hour’.
With pregnant women, this is even more important, as Mums undergo changes to their cardiovascular system and lung function, to cope with the extra demands of the fetus.
This extra stress means mums can get sick even faster.
Things to look for are a high temperature (38 degrees+), low blood pressure, high pulse, not passing urine very much or at all, high respirations, mental confusion, dizziness, and abdominal pain.
5. The Psychological Impact Can Be Massive
My family member was lucky, her experience was getting antibiotics and bouncing back (though she did lose a load of weight and feel exhausted for weeks).
Sepsis can have a psychological impact too.
One of the best accounts of recovering from sepsis I've read was in the WW1 book Birdsong, where the main character, a soldier, is described as:
'Reinhabiting his body cell by cell, each slow inch bringing....some older feeling of what it meant to be alive.'
If you have someone in your care, a friend or family member who has had sepsis, you'd do well to let them do a lot of speaking about their experience and give them the chance to tell their story.
Many Intensive Care Units use a patient diary system so when people are better they have a record of the time they lost.
Being close to death when you've had cancer or heart disease is a bit better understood - sepsis can cause PTSD in the same way.
6. Continuity Of Care Can Help
Just like the National Maternity Review suggests, continuity of care, where one midwife or a small team follow one woman and get to know her, can really improve outcomes.
This is because the symptoms of sepsis can overlap so much with other things and, in the early stages, be tricky to identify.
If you think about a friend or family member you love to bits, it’s far easier to tell when they’re ill than a co-worker or someone you don't know that well, right?
One-to-one care picks up on loads of issues better than standard care.
The National Maternity Review suggests England should move towards more continuity of care models, let's hope that happens!
As you've probably realised, I've changed some of the details of this story, and left out others, so my family member can't be identified.
I hope this helped you get a clear picture of the severity of sepsis, this info could help you save a life.
Now I'd love to hear from you:
1. Have you ever had sepsis? Any experiences you can share?
2. Any close calls as a midwife or student you can tell us about, to help teach us what to look for? (no confidential details please)
Sending all my best for your practice or learning, Ellie x