Stages of Sepsis
- Reviewed By
Anthony C. Lanzone, Founding Partner
Sepsis is the body’s extreme response to an infection. There are three stages of sepsis, with septic shock being the most advanced and serious stage. Nursing home residents tend to have reduced immune function and chronic health conditions, which increase the risk of sepsis. However, most cases can be prevented with proper infection control and quality care.
Medical negligence may be to blame when a nursing home resident becomes septic. Our California nursing home abuse law firm is singularly focused on protecting the rights and welfare of the most vulnerable members of society. If your loved one has developed serious or fatal complications from sepsis, we can help you hold the nursing home accountable. Contact us today for a free case review.
What Is Sepsis?
Sepsis is the immune system’s overreaction to an infection. While any infection can lead to sepsis, it typically starts as a bacterial infection in the lungs, urinary tract, skin, or gastrointestinal tract.
When sepsis sets in, blood pressure drops, and the body loses its ability to provide adequate blood flow to the tissues and organs. It is a medical emergency that requires aggressive treatment. As the condition progresses through the three stages, vital organs become damaged and lose function.
The Three Stages Of Sepsis
Sepsis sets off a chain reaction that begins with an infection and ends in organ failure or death without immediate intervention.
Stage 1 or Sepsis
The first stage of sepsis is also known as systemic inflammatory response syndrome or SIRS. The immune system produces inflammatory substances known as cytokines. These substances help fight infection, but they can cause the blood vessels to dilate and create small clots in the internal organs. This response leads to a chain reaction in susceptible individuals, with the body essentially attacking itself. In many cases, bacteria enter the bloodstream and spread—a condition known as septicemia.
Stage 1 is the most survivable, but it can quickly progress to the more advanced stages without immediate treatment. The clinical signs of stage 1 sepsis include the following:
- Fever of 100.4°F
- Body temperature lower than 96.8°F
- Heart rate of 90 beats per minute or higher, a condition known as tachycardia
- Breath rate higher than 20 breaths per minute, also known as tachypnea
- Very high or very low white blood count
If your loved one develops sepsis, nursing home staff must detect it at this stage to prevent long-term complications and increase your loved one’s chance of survival.
Stage 2 or Severe Sepsis
If blood vessels remain dilated, sepsis can lead to low blood pressure, or hypotension. Hypotension reduces blood flow to the organs and tissues, resulting in oxygen deprivation. Breathing becomes anaerobic, or non-oxygen-producing, leading to lactic acid build-up. If lactic acid levels become too high, the body’s pH can become too acidic. This is known as lactic acidosis.
The heart pumps less blood, further reducing blood flow to the tissues and organs, leading to organ failure. It can cause nausea, vomiting, fatigue, muscle cramps, and rapid, deep breathing. If you see these symptoms in your loved one, it could indicate severe sepsis.
Your loved one may also experience the following symptoms:
- Decreased urine output
- Confusion, disorientation, or sudden cognitive impairment
- Decreased blood platelets
- Shortness of breath or the need for a respirator
- Abdominal pain
Approximately 25 percent of patients with severe sepsis die. Hypotension is the driving factor behind the progression of sepsis.
Stage 3 or Septic Shock
If IV fluids and medication fail to raise blood pressure, the body enters a state known as distributive shock. Tiny blood vessels known as capillaries leak and lose pressure. The blood vessels dilate further, leaking fluid into surrounding tissues, and the heart fills with increasing amounts of blood, making it harder to pump out.
The heart tries to compensate by beating more rapidly. However, it pumps less and less blood with each beat, severely depriving the vital organs of oxygen and nutrients and leading to multiorgan dysfunction syndrome. As many as 50 to 75 percent of patients who reach this stage die.
Septic shock symptoms include the following:
- Very low blood pressure
- Lightheadedness
- Low urine output
- Heart palpitations
- Cold limbs
- Paleness
- Rash
Sepsis Causes and Risk Factors
Anyone at any age can develop sepsis. The risk is highest for those with the following characteristics and conditions:
- Newborn
- Aged over 65
- Pregnancy
- Weakened immune system
- Cancer
- HIV
- Immune disorders
- Diabetes
- Cirrhosis
- Chronic kidney disease
- Chronic liver disease
- Recent course of antibiotics or corticosteroids
- Recent hospitalization, especially in the ICU
- Artificial joints
- Artificial heart valves
- Heart valve abnormalities
- Antibiotic-resistant infections
- Any chronic health condition
- Indwelling catheters
- Hemodialysis treatment
- Burns
- Bedsores
Nursing home residents often have multiple health conditions that contribute to these risks. Quality care and a clean, infection-free environment are crucial to protect nursing home residents from infections and detect sepsis before it worsens.
How Long Does It Take for Sepsis To Be Fatal?
According to the Physician-Patient Alliance for Health & Safety, sepsis can progress rapidly and result in death within 12 hours. The exact sepsis timeline varies from one patient to the next depending on the underlying infection, age, and overall health. The most important factor is intervention. According to the Mayo Clinic, survival increases dramatically when early, aggressive treatment begins within hours of onset.
The overall mortality rate for sepsis is 30 to 40 percent. However, a study published in the International Journal for Equity in Health found that the risk of developing sepsis and dying from it is higher in nursing homes.
What Is The Long-Term Impact Of Surviving Sepsis?
If sepsis is detected and treated early, it may resolve with no long-term complications. However, if it progresses to severe sepsis or septic shock, it can cause permanent damage, known as post-sepsis syndrome. The risk of post-sepsis syndrome increases the more the condition progresses. Symptoms of post-sepsis syndrome include the following:
- Insomnia
- Fatigue
- Shortness of breath
- Disabling pain in the muscles or joints
- Swollen limbs
- Recurring infections
- Weight loss
- Loss of organ function
- Amputation
- Decreased cognitive function
- Hair loss
- Rashes
- Emotional trauma
- Post-traumatic stress disorder
- Depression
- Increased risk of sepsis
Preventing Sepsis In Nursing Homes
Nursing home neglect contributes to the risk of sepsis. Nursing homes can prevent most sepsis cases by doing the following:
- Use proper hand hygiene
- Sterilize instruments
- Isolate residents with contagious infections like MRSA and COVID-19
- Prevent bedsores by repositioning immobile residents often and performing regular skin checks
- Clean wounds and change dressings as prescribed
- Control chronic conditions
- Avoid indwelling catheters
- Report changes in a resident’s condition to the doctor immediately
- Keep resident vaccinations up to date
Sepsis is a medical emergency even in its earliest stage. All nursing staff must know how to detect sepsis in its earliest stage and obtain immediate treatment. A nursing home can be held liable for failing to prevent, detect, or treat sepsis.
Hold the Nursing Home Accountable for Your Loved One Developing Sepsis
If your loved one has suffered from advanced sepsis symptoms such as confusion, shortness of breath, or abdominal pain before being diagnosed with sepsis, the nursing home may have failed to detect it at an early enough stage. The nursing home and staff may be liable for the resulting complications.
We are a skilled elder abuse law firm with a proven track record of holding nursing homes accountable. We can investigate the nursing home and prove staff failed to prevent sepsis or diagnose it early. You or your loved one may be entitled to substantial compensation through a nursing home neglect lawsuit. We have over 75 years of experience and have recovered over $200 million in compensation. Call 1(888) 887-9777 now or contact us online to schedule your free, no-obligation case review.
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.