Ended up at A&E - suspected Sepsis!!

[Carina1962]

Not the best way to spend a Saturday. Had very bad vomiting and diaorreah in the early hours of the morning. My partner rang 111 and they suggested I go to my nearest Walk In Centre, after blood tests they suggested I go to A&E as my lactate reading was 2.7 (should be below 2) so she mentioned the word Sepsis which scared me stupid. My BS was 13 (never been as high as 13 ever). I was very dehydrated so after having fluids on a drip and a second lot of blood tests (which thankfully were all fine) I was sent home this afternoon.

The word gastroenteritis was mentioned, I have never felt so ill in all my life. I recently had a UTI infection and am waiting results from my urine sample to see if there is bacterial growth. The word Sepsis really scared me, I've heard diabetics can be more susceptible to Sepsis but I don't want to feel like I did today. I wasn't tested for Ketones but I'm going to buy test strips in future. Not a very pleasant time.

 

[grovesy]

Sorry to hear you had scare, but are OK.

 

[Carina1962]

Thanks but am a bit confused - it was decided by my local Walk In Centre to pack me off to A&E because I am diabetic and because some abnormalities showed up in my blood tests (one of them lactate was a little high which was a red flag for sepsis). Once I was in hospital, I was put on fluids as I was very dehydrated after very bad sickness and diaorhea and then they took another lot of blood tests and they came back fine so I was discharged and sent home. I forgot to ask the question before leaving but wondered whether I did have sepsis or not? maybe it was suspected so they were taking precautions and once my bloods had stabilised then the sepsis 'red flag' had gone. I'm sure if I did have sepsis I wouldn't have been discharged. Any thoughts?

 

[Amigo]

Sorry you've had such a bad time Carina. Sepsis is a very scary condition with various stages and doctors now seem more primed to notice signs. I do wonder sometimes though whether this causes them to freak people out unnecessarily. I've had sepsis twice with infections (but I have cancer so am more susceptible) and it's a really serious, life threatening condition. Owen posted a thread recently on the subject and there's some really interesting information and posts on there which you may find useful. I've posted the link below.

To be honest Carina, you wouldn't have been discharged with sepsis, you'd be in hospital on IV antibiotics. I had two long hospital stays when I had it.
To be diagnosed with sepsis, you must exhibit at least two of the following symptoms, plus a probable or confirmed infection:

• Body temperature above 101 F (38.3 C) or below 96.8 F (36 C)
• Heart rate higher than 90 beats a minute
• Respiratory rate higher than 20 breaths a minute

http://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/dxc-20169787

This is the start of sepsis, there's then severe sepsis and septic shock which can be fatal. Diabetics are more susceptible to it and it's one of the reasons I keep an eye on my BG's and other obs (however I appreciate my risks are much greater).

This is the previous thread discussing sepsis;

https://forum.diabetes.org.uk/boards/threads/cellulitis-and-sepsis.62422/#post-643623

Hope you feel much better soon,

 

[Northerner]

Hi carina, so sorry to hear this, how are you feeling now? I know nothing about sepsis, but I do recall something about lactic acidosis and its associations with metformin. Was this mentioned at all? I know it to be rare, but really don't know much about it, just remember it being mentioned in the past. I ould speak to your doctor and ask about it if you are still unwell and concerned. This article gives some information about lactic acidosis - note it is very rare so I please don't be alarmed by it as it may be a total red herring!

http://www.medscape.com/viewarticle/714920?src=trendmd_pilot&trendmd-shared=1

Get well soon! 🙂

 

[Redkite]

Hope you're feeling better now, sounds like a horrid illness and a scare when they mentioned sepsis. As the second batch of blood tests were ok, perhaps the slightly high lactate was due to dehydration? Don't panic too much about a BG of 13mmol - even people without diabetes can have a temporary high reading when ill/stressed, I think it's due to the action of stress hormones, e.g.cortisol, making the liver release stored glucose.

 

[Carina1962]

Thanks for your replies and will have a look at the links later. I did have an infection, a UTI as it was confirmed by my GP that my urine sample which they sent off to the Lab showed a bacterial growth which was resistant to the first lot of antibiotics I was subscribed. It wasn't E-Coli (apparently that's the most common UTI one) but can't remember the name of the pesky thing! I too thought they wouldn't have discharged me if I had sepsis and guess the 2nd lot of blood tests wouldn't have been fine if I had but I was very worried when they mentioned the word. I'm trying now to boost my immune system by taking some supplements including cranberry capsules (I did check this out with my GP as I take a lot of medication). My HR was 120 apparently but I had no fever but I was very lethargic as I guess that was due to the dehydration. I will post a separate question in a minute about HR and what is normal or not as I tend to have a high one but don't know why.

 

[graj0]

Not the best way to spend a Saturday. Had very bad vomiting and diaorreah in the early hours of the morning. My partner rang 111 and they suggested I go to my nearest Walk In Centre, after blood tests they suggested I go to A&E as my lactate reading was 2.7 (should be below 2) so she mentioned the word Sepsis which scared me stupid.

I recently had a UTI infection and am waiting results from my urine sample to see if there is bacterial growth. The word Sepsis really scared me, I've heard diabetics can be more susceptible to Sepsis but I don't want to feel like I did today. I wasn't tested for Ketones but I'm going to buy test strips in future. Not a very pleasant time.

Sorry to hear you've had a rough time, some pieces of information might make it a bit less scary.

Sepsis, also referred to as blood poisoning or septicaemia, is a potentially life-threatening condition triggered by an infection or injury. In sepsis, the body's immune system goes into overdrive as it tries to fight an infection. This can reduce the blood supply to vital organs such as the brain, heart and kidneys. (Source - NHS website)

Sepsis can be triggered by an infection in any part of the body. The most common sites of infection leading to sepsis are the lungs, urinary tract, tummy (abdomen) and pelvis. (Source - NHS)

The third bit of info probably more reassuring is:

Many doctors view sepsis as a three-stage syndrome, starting with sepsis and progressing through severe sepsis to septic shock. The goal is to treat sepsis during its early stage, before it becomes more dangerous. (Source - Mayo clinic)

 

[Owen]

If they had really suspected sepsis you would have been conveyed to hospital with immediate iv antibiotics.

Lactate can be raised as a side effect of metformin. There is a thing called lactic acidosis which gives similar symptoms to sepsis.

In laymen's terms, if you have a high fever and any type of pain or redness, then a trip to the emergency room would be better than not. Also very low temperature, below 35 can be a red flag. I will try and image my sepsis flag card.

 

[Amigo]

If they had really suspected sepsis you would have been conveyed to hospital with immediate iv antibiotics.

Lactate can be raised as a side effect of metformin. There is a thing called lactic acidosis which gives similar symptoms to sepsis.

In laymen's terms, if you have a high fever and any type of pain or redness, then a trip to the emergency room would be better than not. Also very low temperature, below 35 can be a red flag. I will try and image my sepsis flag card.

Owen, I think they 'considered' the possibility of sepsis in Carina because of the possible presence of infection and because as she said on another thread, she had tachycardia. However, clearly it wasn't sepsis because she would indeed have been straight in and on IV antibiotics as I was.

 

[Carina1962]

Hi carina, so sorry to hear this, how are you feeling now? I know nothing about sepsis, but I do recall something about lactic acidosis and its associations with metformin. Was this mentioned at all? I know it to be rare, but really don't know much about it, just remember it being mentioned in the past. I ould speak to your doctor and ask about it if you are still unwell and concerned. This article gives some information about lactic acidosis - note it is very rare so I please don't be alarmed by it as it may be a total red herring!

http://www.medscape.com/viewarticle/714920?src=trendmd_pilot&trendmd-shared=1

Get well soon! 🙂

For some reason I can't open your link but have requested my password so hopefully will be able to open it and read it later. I have to say I am much more knowledgeable on sepsis than I was before and is the only good thing that has come out of my experience last Saturday. I have also tried to educate my daughter as I have 2 young grandsons (aged 10 and 6 months) and only the other week my daughter said she took my 6 month old grandson to A&E to get him checked out as he was projectile vomiting quite a lot. I feel angry that we are not alerted and educated more about Sepsis, don't know if it is not to scaremonger the public but it should be made more aware to the general public. I had someone say to me at work "what's sepsis?" and I'm sure there are a lot more out there asking the same thing. What I have now changed for myself is to try and prevent future UTI's if I can by either drinking cranberry juice or taking cranberry capsules (my GP recommended I try it) and also to try and boost my immune system with a few additional supplements like garlic capsules and probiotic supplements. I take a lot of medication and checked with my doctor if it was OK to take these and she said Yes so will give it a go.

 

[grovesy]

For some reason I can't open your link but have requested my password so hopefully will be able to open it and read it later. I have to say I am much more knowledgeable on sepsis than I was before and is the only good thing that has come out of my experience last Saturday. I have also tried to educate my daughter as I have 2 young grandsons (aged 10 and 6 months) and only the other week my daughter said she took my 6 month old grandson to A&E to get him checked out as he was projectile vomiting quite a lot. I feel angry that we are not alerted and educated more about Sepsis, don't know if it is not to scaremonger the public but it should be made more aware to the general public. I had someone say to me at work "what's sepsis?" and I'm sure there are a lot more out there asking the same thing. What I have now changed for myself is to try and prevent future UTI's if I can by either drinking cranberry juice or taking cranberry capsules (my GP recommended I try it) and also to try and boost my immune system with a few additional supplements like garlic capsules and probiotic supplements. I take a lot of medication and checked with my doctor if it was OK to take these and she said Yes so will give it a go.

Sepsis is a relatively new term for what was previously know more commonly as blood poisoning.
I thought that the current think on cranberry juice being useful in UTI's was now questionable.

 

[Carina1962]

Sepsis is a relatively new term for what was previously know more commonly as blood poisoning.
I thought that the current think on cranberry juice being useful in UTI's was now questionable.

Sepsis is a relatively new term for what was previously know more commonly as blood poisoning.
I thought that the current think on cranberry juice being useful in UTI's was now questionable.

How do you mean questionable? as in it's not proven they work? My GP said to try them and a couple of people at work swear by them so I can just give it a go and see although it might take a while to notice any difference. One of my work colleague's grandmother used to swear by them and put it down to them for her not getting recurrent UTI's although my daughter (who is also prone to UTI's) was told by her own doctor that they don't work. All I can do is try it for myself.

 

[Amigo]

Sepsis is a relatively new term for what was previously know more commonly as blood poisoning.
I thought that the current think on cranberry juice being useful in UTI's was now questionable.

Sepsis isn't actually blood poisoning or septicaemia Grovesy.
'Although sepsis is often referred to as either blood poisoning or septicaemia, these terms refer to the invasion of bacteria into the bloodstream.

Sepsis can affect multiple organs or the entire body, even without blood poisoning or septicaemia.'

 

[Owen]

Just to show you how hot the topic is, this is the cover of todays paramedic insight.

 

[grovesy]

How do you mean questionable? as in it's not proven they work? My GP said to try them and a couple of people at work swear by them so I can just give it a go and see although it might take a while to notice any difference. One of my work colleague's grandmother used to swear by them and put it down to them for her not getting recurrent UTI's although my daughter (who is also prone to UTI's) was told by her own doctor that they don't work. All I can do is try it for myself.

Yes that is what I meant not proven. Even NHS choices website say it , I looked at in the last week.

 

[Owen]

Algorithm for sepsis

Are any two of the following present?
1 temp >38.3 or 6
2 respiratory >20bpm
3 heart rate >90bpm
4 confusion or reduced alertness
5' glucose >7.7mmol unless diabetic

Rule out other infection then if any of the next list is shown, start treatment for sepsis

Heart rate >130bpm
Respiration >25 or. <8
O2 saturation <91% unless COPD
Systolic bp <90
Pupuric rash

 

[Amigo]

Algorithm for sepsis

Are any two of the following present?
1 temp >38.3 or 6
2 respiratory >20bpm
3 heart rate >90bpm
4 confusion or reduced alertness
5' glucose >7.7mmol unless diabetic

Rule out other infection then if any of the next list is shown, start treatment for sepsis

Heart rate >130bpm
Respiration >25 or. <8
O2 saturation <91% unless COPD
Systolic bp <90
Pupuric rash

That criterion confuses me a bit to be honest Owen because you need a confirmed or probable infection plus 2 of the qualifying symptoms in the first list to be suspected of having sepsis (I had 4 plus the infection).
What do you mean by 'rule out other infection and start treatment if any of the second list is shown?' Maybe I'm misunderstanding it but I'd have thought it would say, 'confirm infection and start treatment'.

 

[Owen]

No, for instance if there is clear early stage cellulitis, then the patient would be transferred urgently, as this is the stage before sepsis, same with positive results for UTI pneumonia etc. They are different stages of diagnosis. If you notice the first list is kind of repeated again but with more severe readings. These are just guidelines, so you have to factor experience and clinical knowledge, which will often kick in and overrule.

 

[Carina1962]

Hi carina, so sorry to hear this, how are you feeling now? I know nothing about sepsis, but I do recall something about lactic acidosis and its associations with metformin. Was this mentioned at all? I know it to be rare, but really don't know much about it, just remember it being mentioned in the past. I ould speak to your doctor and ask about it if you are still unwell and concerned. This article gives some information about lactic acidosis - note it is very rare so I please don't be alarmed by it as it may be a total red herring!

http://www.medscape.com/viewarticle/714920?src=trendmd_pilot&trendmd-shared=1

Get well soon! 🙂

Didn't know about Metformin and lactic acidosis - just when you think you know everything about diabetes then something else comes up. I think I'll mention this to my GP. Also, I was thinking of phoning up the Medical Centre and the hospital tomorrow to find out what my numbers were when I was admitted to A&E. I know my BS level was 13, my lactic level was 2.7 (should have been 2 or below) but I don't know what my BP was and oxygen saturation levels were before admitted - would be good to know.