Join us on Tuesday 1st May for a webchat on Sepsis with Dr Ed Gaynor

[RachelMumsnet]

Following on from this thread we’ve organised a webchat about sepsis with Dr Ed Gaynor.

Ed has been a paediatrician for 10 years looking after babies and children, working in London and the South East of England. He now specialises in paediatric gastroenterology - problems with a child’s digestive system.

He is a clinical fellow for the National Medical Director for the NHS in England, and has helped to develop resources to enable parents to identify when a child might be unwell. Such as the NHS Choices video: “Spotting sepsis in the Under 5s”

Having spent a career diagnosing and treating children with severe infections, he would like to use his experience to help mumsnetters to learn how to identify signs and symptoms of sepsis early.

Sepsis is a rare but serious complication of an infection, where the body’s immune system goes into overdrive, setting off a series of reactions that can lead to a body’s organ to fail, and in some cases, death. The aim of this webchat is to empower parents with the knowledge they need to recognise the potentially deadly symptoms, so they can spot sepsis as early as possible and seek urgent medical help. Please note Dr Gaynor will not be able to diagnose any specific conditions during the webchat.

Join us on Tuesday (1st May) between 9 and 10pm where Dr Gaynor will be answering your questions on the signs and symptoms of sepsis, or post your questions in advance on this thread. More information about what to look out for in babies and children can be found on our webpage Sepsis in babies and children

My first thought was avoid rusty nails on packing cases! See it is Archers inspired. Great idea for a webchat.

Great idea for a webchat, I spent 2 weeks I hospital last year for sepsis and live in an atrocious area for ambulance response times so I do worry about my children taking a sharp downturn due to a severe illness.

Thanks MNHQ for being informative as always.

A guest writer spoke on mn of her husband dying of this and mentioned a jab we can get.
It won't stop sepsis but it could help, something to do with the meningitis strain. Can you clarify this.

Also are hospitals on red alert for it.... Should we the patients be asking for it to be ruled out?

It’s so difficult to spot though isn’t it? A junior paediatrician didn’t identify it in DS, didn’t even get a blood test done or check respiratory rate.

Her boss however had him on an iv within an hour. I know a couple of things to look out for now but he certainly didn’t seem so ill to me (he’s ok now).

Thanks for agreeing to do this webchat, Dr Ed.

We often have threads on here by people asking other posters for advice on whether they should go/take their child to A&E or wait until the next day to see their GP.

This is of particular concern because posters are aware of the pressures the NHS is under at the moment

Can you outline what to look out for, what needs immediate medical advice/999/A&E and what can safely be 'watch and wait'?

It’s so difficult to spot though isn’t it?

It really is. I developed sepsis due to retained tissue after a section. When the MW came out to do my home visit she said my symptoms were probably my milk coming in and/or tiredness. When I started vomiting later that day and couldn't get warm, I rang her and she said it must be a bug. I tried to go to bed to sleep it off but couldn't sleep because I couldn't get warm and was vomiting bile, I also told DH I was dying and gave him instructions which is when he decided that it wasn't a bug and rang OOH.

Does sepsis present differently in children to adults and is there any one single symptom that immediately pinpoints it as sepsis rather than general illness?

Can you outline what to look out for, what needs immediate medical advice/999/A&E and what can safely be 'watch and wait'?

I second this.

As a three time sepsis survivor I went to the doctors with flu, just two hours later I was in ICU. I can honestly say I would still probably not be able to tell the difference.

Is there anything in particular I should watch out for, I have autoimmune neutropenia and find it gets seen as a "children grow out of condition" (I was diagnosed at 31!)
It is making me more wary and wanting to be aware of sepsis, particularly neutropenic sepsis (I take GCSF)

What can we do as lay people to get our health care professionals to rule sepsis out?

Lost my DF to sepsis last year. Had the mad dash for flight home to NI to be with him. Cannot praise the staff of intensive care enough, they really did pull out all the stops to try and save him but there isn't really much you can do with the stable door after the horse has bolted.
It was them who helped me explain to rest of family how V badly let down he was by the staff of his gp's practice.
Using the Sepsis UK website (very useful) I was able to show family that he was at least 2 red flags for sepsis (literally ticking timebomb: open wounds on legs, constant infections, diabetic, elderly) and yet my DM (his main carer) was never warned of the symptoms, which after discussion with DM he'd been showing for at least 48 hrs before ambulance called by gp's receptionist.
I think one choice quote from an ICU nurse says it all: "last practice nurse who dressed his legs should've gone to specsavers".
We were that angry that I broke "tradition" and didn't inform gp of his death (as far as they were aware he was still in icu) until after funeral as we felt we couldn't have been held responsible for our actions when the gp/practice nurse would have visited (customary) during the wake.
We did get an apology (on phone) from his gp (if you could call "We dropped the ball" one) and if it weren't going to cause DM further upset I'd have taken it further.
The cost of the Sepsis UK symptom card the practice could have given my mother and stronger antibiotics he should have had versus the cost of 2 weeks in ICU would be quite an interesting comparison, especially in light of stretched NHS resources.
Apologies for long post/rant

@TooManyWIPs

So sorry, ToomanyWIPs - that's a terrible situation. :(

It can strike hard and fast - someone I know in Australia lost her sister to it as a complication of the flu last year - her sister was autistic and may not have had such noticeable symptoms, because she had a high tolerance to pain, and her mother didn't spot the warning signs. She was transferred to hospital but died there. Prior to her dying they were talking about amputating her hands and feet as she also had necrotising fasciitis :(
Awful thing to have.

My son contracted sepsis from a hornet sting at the base of his spine. Dirt got into the wound and the infection took hold.

By sheer good luck I picked him from a friends and saw him destioriste within 20 minutes. 8 hours before he had been fine!

I turned the car around and got to the children’s hospital within 5 minutes. By then his blood pressure was 70/30.

Within 5 more mins he had 3 doctors working on him. He spent a week in hospital and fully recovered.

This illness attacks with lightening speed.

Thank you for doing this. My DM spent Christmas in hospital with sepsis that was the result of a cat scratch, we nearly lost her and I cannot praise the GP who called the ambulance enough (I'd made her see the GP as I thought she had a kidney infection, turned out that was her adrenal glands haemorrhaging).

I really never knew much about sepsis and now it petrifies me how quickly it happens and how long lasting the effects are if you survive.

I love our NHS.

I can't praise our NHS.

My DM is only alive, despite the negligence of our local hospital, because I happened to be on the phone to my DF when my DM came through the door, having been sent home from the hospital despite loudly telling everyone within earshot there she was having a heart attack.

It turned out that she wasn't having a heart attack but had sepsis. But knew she felt unbelievably awful.

Thankfully, as I could tell there was something very not right, I phoned for a doctor straightaway to come round to check on her. She had gone straight to bed as soon as she got in because she felt so awful and could barely stay awake. The doctor was very concerned as he couldn't wake her at all and so sent her straight back to hospital - she had to be carried down the stairs.

Had I not been on the phone as she got in, she would not have taken my call as she was in bed asleep within minutes. By the time she awoke - if she awoke - in the morning, it would probably have been too late, as the sepsis would have spread. As it was (thanks to my call), by 2am that night, she was back in hospital and on heavy-duty antibiotics. It still took her weeks to recover and she suffered horrendous hallucinations.

I am so angry that all the staff in A&E thought it was OK to send home an elderly woman complaining she was having a heart attack. My dm is not someone who complains about feeling ill at all (she had 4 dcs quite happily with no pain relief). So when she says she's feeling really ill, I know that it's serious.

And this was the third time she'd been sent home from that hospital during this stay - she'd been sent home whilst still unwell with pneumonia on two previous occasions the previous week, and both times she'd had to be brought back on the same day as she was still very unwell.

There is clearly a huge problem in the NHS with a) underfunding and the resultant pressure on beds, meaning that ill, elderly patients are sent home before they're better and b) patients (particularly elderly ones) not being listened to by medical professionals who think they know better and ignore the voice of the patients themselves.

Until the medical establishment sorts out those issues, having patients recognising the symptoms of sepsis is not going to help - if doctors and nurses themselves refuse to listen to patients or send home patients who are suffering from sepsis.

Medical education about sepsis needs to start with medical professionals. How could a hospital SEND HOME a woman suffering from sepsis??

Thank you for this.

I was sent home from hospital last year after a bite only to be readmitted 12 hours later with sepsis. The junior dr I saw in a&e having told me there was nothing to worry about I was later told there was a 40% chance I wouldn't last the day. I have never been so scared in my entire life.

I am now thankful we are having heightened awareness of this awful infection and hopefully fewer people have to go through later diagnosis.

The Sepsis 6 system saved my life. I just want to thank you and all medical professionals who do so much work fighting and raising awareness.

Will be listening with interest to this. Recently liost my DF to sepsis that a major teaching hospital failed to spot, despite us telling them he had sepsis.

I’m in hospital at the moment. I had my appendix removed as an emergency surgery last week. I had sepsis. They ‘say’ my markers are ‘heading in the right direction’ but I’m still worried.

Apparently my CRP is 90, but I can’t find anything online to tell me if that’s ok or not.

I’ve been in various antibiotics, but I’ve finushed them today - they’re not giving me anymore.

They want to send me home. I don’t know what to do as I don’t know if 90 is an acceptable level or not, but I know the risk of getting other infections is high in hospital.

LatteLover really hope you recover quickly, it depends what your markers were before as to whether that's good I think. If they're coming down then you're going in the right direction.

Thanks Cunk apparently they were HIGH, then 160, 133 & now 90

Thanks for the good wishes 😊

Excellent idea & thank you.

We were told normal CRP range was 0-5 mg/L. DS went up to 230 before starting to come down. His wbc was 26 at the worst (normal range for his hospital 3.5-12).

I think you’re best off discussing it with your clinical team to understand their thinking re discharge. If you no longer have a temperature and you don’t need further antibiotics, what would be the benefit of staying in hospital for longer?

And are they going to follow you up as an outpatient?

Sorry you’ve so ill, sounds grim.

My child has asd and picks at themselves.

I've tries to talk to them about sepsis but the compulsion to self harm is strong.

All these entry points in their skin especially their fingers worries me.

Any thoughts?

This will be really useful, will be sure to turn up tomorrow. I've been seeing a lot more publication on this in stores, GPs and chemists.