Action needed to spot and stop sepsis

The Royal College of Nursing has stressed that health care staff must be educated on the signs of sepsis to save tens of thousands of lives lost each year.

Between 1,000 and 4,000 children under the age of five die of sepsis every year in the UK, according to the UK Sepsis Trust. Yet there is not currently a universal, nationally validated system to identify deterioration in child patients.

Sepsis, also known as blood poisoning or septicaemia, is difficult to detect because many of its symptoms, such as a high temperature, are also indicators of other illnesses. It can be the result of a severe infection and without rapid treatment can lead to organ failure, loss of limbs or death because the body’s immune system reverses its usual role and starts to attack organs and tissues.

As part of the Royal College of Nursing’s annual Congress in Liverpool, nurses will urge for a nationwide rollout of a new system to enable signs of deterioration in any patient’s condition to be identified and acted upon quickly. Part of the scheme have been tested at specialist institutions including Great Ormond Street Hospital, monitoring heart rate, respiratory rate, blood pressure, oxygen saturation and temperature.

Donna Kinnair, RCN chief executive, said: "Sepsis in a child is so sudden. You can see a child who comes in looking like they have a common cold. You might send that child home. In a matter of an hour you see the child develop the symptoms of sepsis that are very clearly defined. By the time they have developed the stark symptoms of sepsis there's no way you can come back from that. It's really important that we get a way of ensuring that we diagnose
this accurately.”

Ron Daniels, CEO of the UK Sepsis Trust, commented: “We absolutely support the Royal College of Nursing in calling for the urgent development and dissemination of a national paediatric early warning score. At present, even in the same city, clinicians use a variety of different early warning scores to identify acute illness in children. The result of this is that they communicate with each other and assess the severity of a child’s illness using different tools — different languages even.

“In order to drive things forward, we are going to need a degree of assertiveness from NHS England and NHS Improvement, as we have seen with the system for adults. Having a standardised early warning tool applied across the NHS as we do with adults, will allow the entire clinical community to recognise illness in children in the same way and to work together toward developing a system which responds robustly, reliably and consistently for children of all ages — a system that will allow that community to learn, together, to further refine the tool and make sure it continues saving the lives of children into the future.”