Sepsis: One Nurse Makes a Difference


SEATTLE, Wash. (Ivanhoe Newswire) — Each year, about 1.7 million adults in the US develop sepsis and it kills approximately 350 thousand. Diagnosis is key for preventing organ failure and even death. However, with early symptoms mimicking the flu and covid, there can often be a delay in seeking care. Ivanhoe discovered a Seattle hospital whose solution to that problem saved quite a few high-risk patients.

Agnes Tabisula is not taking anything for granted these days.

She says she is one of the lucky ones who survived sepsis thanks to having a dedicated nurse in her corner.

Agnes says, “She’s not my family or she’s not even related to me, but she cares.”

Jelaine Boyce, RN Care Manager at Valley Medical Center says, “It was just a scary time for her, and I know she didn’t want to burden her family.”

Shortly after moving from Hawaii to Seattle, Tabisula was admitted to the hospital for a series of worsening conditions including a cardiac stent, a foot infection, and kidney abscess.

Hamy Dinh, Manager of Care Management Valley Medical Center explains, “She was a pretty complex case, she had five hospital admissions within the last two months.”

That’s why Valley Medical Center decided to closely monitor Tabisula remotely through their post discharge program.

Nurse, Jelaine Boyce phoned her fifteen times about her condition.

Boyce says, “… She would be honest with me. If I didn’t encourage her to get evaluated, she would have gotten sicker. She would have stayed at home.”

… which led to a sepsis diagnosis by doctors. It is the body’s toxic response to a viral or bacterial infection. And can cause organ damage or failure.

“The worst-case scenario for sepsis would be death. It can start by anything, you know, a little cut in the toe and it just worsens.” Says Boyce.

Fortunately, Tabisula’s sepsis was resolved with fluids and antibiotics.

The World Health Organization says one in five deaths globally are caused by sepsis. Warning signs of sepsis include:  fever, chest pain, shortness of breath, palpitations, nausea and vomiting.

Contributors to this news report include: Jennifer Winter, Producer; Joseph Alexamder-Short, Videographer, Roque Correa, Editor.


REPORT #3112

BACKGROUND: Sepsis is when the body has an extreme reaction to an infection. The body attacks its own organs and tissues, which can lead to tissue damage, organ failure, and death. Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Most cases start before a patient goes to the hospital. Infections that lead to sepsis most often start in the lungs, urinary tract, skin, or gastrointestinal tract. More than 1.5 million people in the United States develop it every year, and at least 350,000 people die from it. Rapid diagnosis and treatment can prevent up to 80 percent of sepsis fatalities.

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SYMPTOMS AND TREATMENT: The symptoms of sepsis can vary depending on the stage of the condition and the underlying cause, but some common signs and symptoms can include fever or low body temperature; rapid heart rate or breathing; confusion or disorientation; extreme fatigue or weakness; chills or shivering; reduced urine output; abdominal pain, nausea or vomiting; skin rash or discoloration; difficulty breathing; low blood pressure; elevated white blood cell count; elevated lactate levels. It is treated with antibiotics and IV fluids. In most cases broad-spectrum antibiotics will be administered. Once blood tests have been performed, antibiotics that target the particular strain of bacterium responsible for the infection may be used.


NEW STUDY FOR INTERVENTION: A trial out of Vanderbilt University Medical Center compared two early interventions in the treatment of patients with sepsis. It causes dangerously low blood pressure, which is typically treated with intravenous (IV) fluids and/or a vasopressor, a drug that causes constriction of the blood vessels. Whether treatment of sepsis-induced low pressure should primarily be treated with IV fluids or vasopressors has been debated for decades with no clear answer. In the Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS) trial, investigators compared these two approaches for treating sepsis. Trial results demonstrated that both a resuscitation strategy that relied on large volume fluid administration and one that relied on lower fluid volumes with greater use of vasopressors led to nearly identical survival. “There has never been good data to inform us on what volume of fluid we should be giving to our sickest septic patients and when we should be starting vasopressors,” said Wesley Self, MD, MPH, Senior Vice President for Clinical Research at VUMC. “The CLOVERS trial results are important because they provide strong data showing that supporting blood pressure with either IV fluids or vasopressors can result in similar outcomes.”


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Kristin Bidwell

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