Sepsis and Post Sepsis Syndrome

What is Sepsis?

Sepsis is a rare but serious complication of an infection. Without quick treatment, sepsis can lead to multiple organ failure and death. It is caused by the way the body reacts to infection. The infection may start in one part of the person’s body or it may be widespread. With sepsis, the body’s immune system goes into overdrive. This can lead to a major decrease in blood pressure, which can mean the blood supply to vital organs such as the brain, heart and kidneys is reduced.

Infections that give rise to sepsis are common and include lung infections (pneumonia), urine/kidney infections, infections in wounds, bites and problems like burst ulcers.

How is Sepsis diagnosed?

If you have been diagnosed with sepsis it is often based on simple measurements such as temperature, heart rate, breathing rate and sometimes through blood tests.

Other tests can help determine the type of infection you have, such as:

• Blood tests
• Urine or stool samples
• A wound culture – where a small sample of tissue, skin or fluid is taken from the affected area for testing
• Respiratory secretion testing – taking a sample of saliva, phlegm or mucus
• Imaging studies – such as x-ray, ultrasound scan or computerised tomography (CT scan)

Who can get Sepsis?

Anyone can get sepsis but it is more common in older people, those with diabetes or a kidney condition and people with cancer, especially those receiving chemotherapy or immunotherapy.

What to expect while in hospital?

We aim to deliver a bundle of care called the Sepsis 6, this includes:

1. Ensure senior clinicians attend – this is to allow an early review by a senior decision maker and to see if there is an alternative diagnosis.
2. Give oxygen if required – you will be attached to a machine that reads your oxygen saturation level and this is used to help determine if oxygen is needed.
3. Blood tests will be taken – this will include blood cultures, full blood count, lactate, urea and electrolytes. The blood culture test allows us to understand the type of infection to ensure the correct use of antibiotics.  The other blood tests help us to understand how the infection is compromising other major organs so we can treat accordingly.
4. Antibiotics will be given to help with the infection. They work by killing bacteria or preventing them from spreading.
5. May require intravenous fluids (IVT) if you are dehydrated and have low blood pressure. Intravenous fluids is the administration of fluids directly into the vein via a small cannula.
6. A clear plan will be made for ongoing care and monitoring – this will include regular observations of your blood pressure, heart rate, oxygen saturations, monitoring of fluid input and monitoring of urinary output (a urinary catheter may be required as you are at risk of developing an Acute Kidney Injury (AKI)).

Critical Care and Sepsis

Some patients may require an admission to Critical Care as a result of sepsis. Critical Care is where the most unwell patients in the hospital are treated. Critical Care includes both the Intensive Care Unit (ICU) and High Dependency Unit (HDU).

In Critical Care, you will receive treatment to support one or more organs which may be failing.

This could be support for following organs:

• The lungs, which includes the use of a ventilator (breathing machine)

• Heart and circulation issues requires very strong medication to support the blood pressure and heart rate

• If you are struggling to produce urine you may be placed on to a dialysis machine to take over your kidney function

You will require invasive lines, which will allow for close monitoring.

The invasive lines include:

• Arterial line – An arterial line is a small cannula that is placed into the artery usually in your wrist. It allow us to continually monitor blood pressure and take blood samples easily.

• Central line – A central line is an access device placed into a large vein usually within the neck or groin to allow multiple access ports and the ability to infuse fluids and high strength medications.

• Vascath line – A Vascath is an access device inserted into a large vein in your groin or neck and is used for patients who require continuous dialysis to help with their kidneys.

• Urinary catheter – A urinary catheter is a tube inserted down the urethra into the bladder to allow close monitoring of urine output.

What happens after Sepsis?

The majority of people who have suffered sepsis that is mild or uncomplicated will make a full recovery. However, some patients who have had severe sepsis and are in hospital because of it may suffer with long-term problems. This group of problems has become known as Post Sepsis Syndrome (PSS). These problems commonly last 6 to 8 months but can go on for years for some. The reasons why some people get Post Sepsis Syndrome are poorly understood, but these can have life-changing effects on you and your family. These effects can be physical or psychological.

Physical symptoms/ effects of PSS can include:

Psychological and emotional symptoms of PSS:

What can you expect during recovery?

Going home after a serious illness can be very scary and frustrating.

Everyone is different and will recover at different paces. Most people recover from PSS but it can be a difficult time even though you have left the hospital and look better, you are still not feeling very well.

Try not to push yourself too hard as this may delay your recovery. Listen to your body if you become tired, stop and rest. You may feel more emotional than normal or low in mood and these are quite normal after a life changing experience. This may cause problems with your employer or family who expect you to be back to normal. It may help to share this leaflet with them or ask them to visit the UK Sepsis Trust website (provided at the end of the leaflet).

Returning to normal life can be very daunting and you may benefit from physical or psychological support if things are not improving over time. Speak to your GP for advice and help.

What do I do if the infection recurs?

Some people who had sepsis find that they are more prone to infections afterwards. This is because the immune system is not as effective in the years following sepsis. This is particularly true if you have underlying health problems. This can be very frightening as you may be concerned that every time you have an infection you could get sepsis again.

It is important to get medical attention if you feel unwell, experience obvious symptoms of an infection or have a high temperature. Prompt treatment with antibiotics will usually prevent any recurrence of sepsis.

It is however important for you and people close to you to be aware of this problem, not to neglect any infections you have but to make sure they know the Signs of Sepsis:

S -slurred speech or confusion

E – extreme shivering or muscle pain

P – passing no urine (in a day)

S – severe breathlessness

I – it feels like you are going to die

S – skin mottled or discoloured

When can I return to work?

You may be apprehensive about returning to work. If you feel you are not fully recovered, you should speak to your employer to see if you can have a phased return to work or change your role to something that would be more suitable.

Sick pay varies between employers. There is a benefit called ‘Personal Independence Payment (PIP)’ that is designed for people who have experienced a life changing illness or disability.

However, you can only claim after a three-month period from the start of your illness. Please see the government website within further information for more details.

Further Information

• Citizens Advice’s benefits web pages provide lots of useful information on claiming benefits and in some cases will assist with claims and form filling

• https://www.gov.uk/pip

• The UK Sepsis Trust also provides useful information for patients and relatives. The UK Sepsis Trust Home Page | What is Sepsis? | Sepsis Symptoms or contact 0808 800 0029

• NHS Choices www.nhs.uk

References

• NHS UK Treatment and recovery from sepsis – NHS (www.nhs.uk) last accessed 27/10/22
• UK Sepsis Trust Post Sepsis Syndrome | The UK Sepsis Trust last accessed 27/10/22

• Sepsis.org Post-Sepsis Syndrome – Sepsis Alliance last accessed 27/10/22

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]

Leaflet Reference: PIL1397
Date for Review: 08/02/2026