States may be key battleground to combat deadly sepsis complications in kids

sepsis-300x249Although public health officials have launched national campaigns against sepsis, it may be that new initiatives at the state and local levels will be more effective in battling the deadly scourge, particularly as it harms kids.

Sepsis, experts say, happens when the body is overwhelmed by infection and responds by shutting down key organs. It can lead to tissue damage, organ failure, and death. It’s difficult to predict, diagnose, and treat. As Stat, the online news service, reports:

Sepsis hospitalizes some 75,000 children and teens each year in the United States. Nearly 7,000 will die, according to one 2013 study. That’s more than three times as many annual deaths as are caused by pediatric cancers. And some of the children who survive sepsis may suffer long-term consequencesincluding organ damage and amputated limbs.

The federal Centers for Disease Control and Prevention, I’ve written, has declared a national emergency, urging doctors and hospitals to be more aware of sepsis and to take fast measures to save lives. Now, Stat says, dozens of Texas hospitals are campaigning to slash childhood sepsis deaths and diagnoses of severe sepsis at participating institutions by 75 percent by the end of 2020.

They’re pushing to share information among themselves, raise public awareness, and most importantly to get their medical staffs to diagnose and treat sepsis cases among kids with the alacrity demanded. It won’t be easy.

Sepsis often starts in children younger than 1 with infections to the lungs, urinary tract, skin, and gut. Patients display symptoms including: diarrhea, vomiting, sore throat, as well as shivering, fever, or feeling very cold, extreme pain or discomfort, clammy or sweaty skin, confusion or disorientation, shortness of breath, and a high heart rate. Doctors say that low blood pressure, areas of hot, reddened skin, pain, and confusion that won’t lift are all red alerts that sepsis may be occurring.

Almost three-quarters of patients with sepsis are seen by doctors and nurses who can too often miss its symptoms. Failure to treat sepsis quickly, perhaps within hours, and aggressively with antibiotics and other means can condemn patients to progress to deadly septic shock.

Kids with sepsis can go from sort of OK to dire shape in a blink. And their steep decline and deaths can be nothing less than tragic, as occurred with a much-publicized case involving New Yorker Rory Staunton, 12. He was a basketball player who dove for a loose ball, and cut his arm in a game at his private school. The cut got infected, and a day after his injury, a Thursday, the boy was sick and seen in a New York hospital. He did not respond to treatments, and a day more and he was hospitalized. He was dead two days later of septic shock. That was back in 2012.

His parents campaigned with New York officials to improve the diagnosis and fast treatment for sepsis—the New York Times says the resulting program was a first of its kind at the state level. As the newspaper reported, five years later, based on a new study:

[M]ore people with sepsis were being identified and treated earlier, and that fewer of them were dying. …. beginning in 2014 and continuing into the third quarter of 2016 ….for adults who got faster treatment, the odds of dying declined by 21 percent. …The picture with children was complicated: Although three times as many children were being treated quickly, the mortality rate fluctuated but did not decline. However … the number of pediatric sepsis patients was too small for existing statistical tools to generate meaningful results.

In my practice, I see the consequences of negligent treatment of children. It’s great to know that doctors and hospitals are attacking sepsis, especially in kids, with federal and state programs. Let’s hope these efforts, which work, can at the same time target hospital acquired infections, which I’ve written about. These afflicted 650,000 already ailing Americans and contributed to 75,000 deaths in 2011.

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