Sepsis for health professionals

Sepsis is a life-threatening condition that arises when the body’s response to an infection injuries its own tissues and organs and is a major cause of morbidity and mortality worldwide.

Causes of sepsis

Sepsis can occur with any infection, most commonly respiratory, abdominal, urinary, and skin and soft tissue infections. Many different organisms can cause sepsis, including bacteria, fungi and viruses, but bacteria are the most common. Sepsis can occur in widespread or localised infection.

Recognising sepsis

Sepsis may occur in patients both in the community and those already being treated in hospital. In hospitalised patients, the Rapidly Deteriorating Patient Observation Chart may provide early indicators of possible sepsis. See example RDR chart (PDF 272KB).

Early diagnosis and prompt treatment of sepsis is essential, including the administration of antibiotics and supportive therapy.

Signs and Symptoms of sepsis

In addition to signs of infection, symptoms can be different for adults and children.

Adults signs

Suggested signs of sepsis may experience one or more of these:

  • fast breathing and/or heartbeat
  • confusion, slurred speech or disorientation
  • difficult to rouse or wake
  • feeling very hot or cold / fever or shivering chills
  • weakness or aching muscles
  • not passing much (or any) urine
  • a new rash, discoloured skill or clammy sweaty skin
  • feeling very unwell, extreme pain or like you're 'going to die".

Children and infant signs

Children and infants may deteriorate rapidly.

Suggested signs of sepsis may experience one or more of these:

  • fit or convulsion
  • fast or slow hear rate
  • fast breathing or long pauses in breathing
  • floppy, lifeless body
  • blotchy, discoloured, very pale or bluish skin
  • drowsy, difficult to wake up or confused
  • rash that doesn't fade when pressed
  • fever or very low temperature
  • not passing urine (or no wet nappy) for several hours
  • a lot of pain or very restless
  • high pitched cry
  • persistent vomiting and not feeding or eating.

Signs suggestive of septic shock 

  • Mottled or cold peripheries
  • Capillary refill time > 3seconds
  • Systolic BP < 90 mmHg or MAP < 60 mmHg or ≥ 40mmHg from baseline
  • Purpuric rash
  • Arterial or venous lactate ≥ 2 mmol/L
  • Oliguria (urine output less than 0.5 mL/kg/hour)

Treatment of sepsis

Sepsis is a medical emergency

Treatment of sepsis includes the prompt administration of antibiotics (aim to administer within one hour of suspecting sepsis), source control, intravenous fluid therapy and organ system support with vasopressor drugs, mechanical ventilation, and renal replacement therapy, as required.

Immediate management of sepsis

  1. Assess for airway patency and administer oxygen
  2. Immediately obtain IV access, blood cultures and baseline blood tests (including lactate) prior to taking diagnostic samples
  3. Prescribe and administer antibiotics within 60 minutes – Refer to SA Health Antimicrobial guidelines
  4. IV fluid bolus if patient showing signs of shock/hypoperfusion; repeated as required
  5. If sepsis is suspected, the patient is promptly reviewed by an experience clinician; the patient is escalated to a higher level of care or intensive care if transient or no response to treatment 
  6. Identify source of sepsis if not already clear by taking other diagnostic samples (sputum, urine, pus)
  7. Monitor fluid balance and urine output

Further information

For further information on Sepsis for health professionals, contact SA Health's Infection Control Service on (08) 7425 7161.