SURVIVAL rates for sepsis patients in Worcestershire have increased dramatically thanks to new measures by Worcestershire Acute Hospitals Trust.

Sepsis, also known as blood poisoning, is a rare but serious complication of an infection. Without quick treatment, sepsis can lead to multiple organ failure and death.

Just over a year ago the mortality rate due to sepsis at the county’s three general hospitals – Worcestershire Royal Hospital, the Alexandra Hospital Redditch and Kidderminster Hospital and Treatment Centre - was 49 per cent higher than the national average.

Two months later in May 2017 that rate had dropped to 26 per cent below the national average signalling a remarkable turn-around. The latest figures, which are for December 2017, show Worcestershire hospitals’ mortality rate from the condition is still well under the national average – 17 per cent below.

The trust has been running an awareness project in the hospitals to focus staff on looking for sepsis, rather than just waiting for it to become obvious.

The trust has made improving survival rates of patients identified as having sepsis a top clinical priority and this has resulted in an outstanding reduction in the death rates.

The project in Worcestershire’s hospitals has ensured more patients are screened for sepsis, with those found to have the condition being treated much more quickly. A new dedicated sepsis nursing job was created to oversee clinical advice and staff training about the condition.

Over 1,000 clinical members of staff across the county have been trained on specifically identifying the condition in patients, which has helped to detect and treat those with the condition more effectively.

Sepsis can be difficult to diagnose because early symptoms can be confused with other conditions such as a kidney infection, pneumonia or fever. This highlights the need for greater awareness of its causes, signs and symptoms.

Early symptoms of sepsis in older children and adults can include a high temperature (fever) or low body temperature, chills and shivering, confusion, cold or blotchy hands and feet, and not passing as much urine as normal.

As well as extensive training for staff, the project has involved a new approach to diagnosis, patient care and treatment to increase prevention, diagnosis and management of sepsis.

The staff training has included a video with in depth information about the condition, how to spot it and what to do to tackle it early. This is available on the staff intranet, through internal bulletins and on some of the TVs around the hospital sites.

The trust has also produced information stands where it used hard copy print outs of the information included in the video.

Specialist IT improvements have also helped bring in line systems across Worcestershire’s hospitals so that staff can more easily and quickly report patients who have been identified as having sepsis.

Patient information leaflets were produced to provide sepsis survivors, and those more at risk of developing sepsis, with information about the condition and its treatment as well as their rehabilitation and recovery.

Dr Mike McAlindon, Clinical Lead for the Sepsis Quality Improvement Project at Worcestershire Acute Hospitals NHS Trust said: “Sepsis is a cause of death in people of all ages and is a major cause of avoidable mortality. Thanks to the hard work of staff across our trust we’ve managed to dramatically reduce the mortality from sepsis over the past year.

“This is good news for patients as now they can be assured that if they come to hospital with sepsis, they will receive a good level of care, giving them a better chance at survival.”

There are around 260,000 cases of sepsis a year in England and around 44,000 people die every year as a result of the condition. Anyone can develop sepsis after an injury or minor infection, although some people are more vulnerable.

Early symptoms of sepsis in older children and adults may include:

• A high temperature (fever) or low body temperature.

• Chills and shivering.

• A fast heartbeat.

• Fast breathing.

In some cases, symptoms of more severe sepsis or septic shock (when your blood pressure drops to a dangerously low level) develop soon after. These can include:

• Feeling dizzy or faint.

• A change in mental state – such as confusion or disorientation.

• Diarrhoea.

• Nausea and vomiting.

• Slurred speech.

• Severe muscle pain.

• Severe breathlessness.

• Less urine production than normal – for example, not urinating in a day.

• Cold, clammy and pale or mottled skin.

• Loss of consciousness.

People are urged to get medical advice immediately by ringing NHS 111 if they have had an infection or injury and developed the early signs of sepsis.

Severe sepsis and septic shock are medical emergencies. If anyone thinks they or someone in their care has one of these conditions, they should go straight to A&E or call 999.

People should go straight to A&E or call 999 if a child under five years old has any of the following symptoms:

• Mottled, bluish or pale appearance.

• Lethargy or difficulty in waking up.

• Is abnormally cold to touch.

• Is breathing very fast.

• Has a rash that does not fade when it is pressed.

• Has a fit or convulsion.

Parents and carers should get medical advice urgently from NHS 111 if their child has any of the symptoms listed below, is getting worse or is sicker than they would expect (even if their temperature falls). The message to anyone caring for a child is “trust your instincts”.

Temperature

• Temperature over 38C in babies under three months.

• Temperature over 39C in babies aged three to six months.

• Any high temperature in a child who cannot be encouraged to show interest in anything.

• Low temperature (below 36C – check three times in a 10-minute period).

Breathing

• Finding it much harder to breathe than normal – looks like hard work.

• Making "grunting" noises with every breath.

• Can't say more than a few words at once (for older children who normally talk).

• Breathing that obviously "pauses".

Toilet/nappies

• Not had a wee or wet nappy for 12 hours.

Eating and drinking

• New baby under one month old with no interest in feeding.

• Not drinking for more than eight hours (when awake).

• Bile-stained (green), bloody or black vomit/sick.

Activity and body

• Soft spot on a baby's head is bulging.

• Eyes look "sunken".

• Child cannot be encouraged to show interest in anything.

• Baby is floppy.

• Weak, "whining" or continuous crying in a younger child.

• Older child who's confused.

• Not responding or very irritable.

• Stiff neck, especially when trying to look up and down.