Treating Sepsis

Sepsis is one of the leading causes of death. As infection spreads throughout the body, the bodily systems can become dysregulated. The resulting organ dysfunction can lead to life-threatening events. One of the primary goals of sepsis treatment is to prevent septic shock. Septic shock increases a client’s risk of dying.

Signs and Symptoms

Early signs of sepsis include fever, confusion, dyspnea, pain, and diaphoresis. The nurse should monitor clients closely for these symptoms as early correction of these conditions can improve client outcomes. Late signs of sepsis include hypotension, respiratory failure, and loss of consciousness.

Testing

Labs should be obtained when initiating treatment for sepsis. While labs should not delay treatment of the client, obtaining samples as soon as possible is preferred. A nurse should anticipate obtaining samples for a complete blood count (CBC), blood cultures, serum lactate, arterial blood gas, and urinalysis. Clients may also require imaging such as a CT scan or MRI to help identify a source of infection that is contributing to the sepsis.

Treatment

Correcting sepsis initially focuses on treating the underlying cause(s). Sepsis develops secondary to infection. Septic shock is when life-threatening hypotension begins as part of the infectious cascade.

Antibiotics

The initial defense against sepsis involves starting broad spectrum antibiotics until the infectious organism is identified and tested for antibiotic sensitivities. Once the sensitivities return, antibiotic therapy can be narrowed to best treat the identified organisms. While the infection is being treated, the client may require supportive treatment to manage other symptoms of sepsis and organ dysfunction.

Fluids

Intravenous fluid administration and intravenous fluid boluses should be used to treat clients experiencing early hypotension. If hypotension is not responsive to fluid resuscitation, vasopressors may be required to support the client’s blood pressure. Common vasopressor medications used in sepsis include norepinephrine, epinephrine, vasopressin, phenylephrine, and dopamine.

Respiratory Support

Clients may require oxygen if they are having difficulty breathing. Difficulty breathing can be a direct result of the sepsis cascade or secondary to fluid overload from the intravenous fluid boluses. Some clients may experience respiratory failure and require intubation and mechanical ventilation.

Other Supportive Therapies

Finally, other supportive therapies may be indicated depending on the severity of the sepsis and the client’s condition. Electrolyte imbalances should be corrected. These therapies include surgical debridement of infected tissues, blood product infusions, initiation of nutrition via enteral or parenteral route, thromboembolism prophylaxis, gastric ulcer prevention, and sedation.

Sepsis can quickly become life-threatening for clients. It develops from an infection that affects the body systemically. Early recognition and treatment is essential to improving client outcomes.