Sepsis: A mother's tale
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It's every parent's worst nightmare when your instinct is telling you that something is wrong with your child, but you (or in some cases even the medical professionals) can't pinpoint what. Sepsis claims around 40,000 lives each year in the UK alone, but new research claims that the latest advice from the National Institute of Health and Care Excellence (NICE) could help prevent between 5000 to 13,000 of those deaths. Expert clinical negligence lawyer, Elizabeth O'Mahony, shares her own personal experience of sepsis and discusses the importance of being aware of the symptoms to help prevent a delayed diagnosis.
I had never really considered sepsis to be a threat to me or my family. Like many people, I thought it was something that probably only happened if you were unlucky enough to get an infection after an operation, or lived in a country where basic medical care is lacking. So as a mum to a one year old daughter it was the last thing on my mind when she developed a cough. Now, having gone through this terrifying experience and having acted in several clinical negligence cases concerning sepsis I am well aware of the dangers.
Sepsis is a rare but serious complication of an underlying infection such as pneumonia or urinary tract infection - but without quick treatment it can lead to multiple organ failure and death. Open wounds prone to infection are also another catalyst for Sepsis to take hold, so people recovering from an operation or who have suffered an accident can be vulnerable to the risk.
The craziest thing is that it is your own body that creates it! Your immune system (the body's defence to infection) goes into overdrive, overreacting to try and stop the invading infection, but instead goes too far and starts attacking your own body in the process. The symptoms are fairly non-specific and unless you are already aware or being monitored for an underlying condition, such as a chest infection (pneumonia) or as an inpatient post-operation, then the symptoms can be all too easy to miss or misinterpret as just being unwell…until it becomes really serious. This is especially true in babies or infants, a fact I sadly I know all too well.
Falling off a cliff
My one year old daughter, who had been born prematurely at 32 weeks, had a persistent cough for about three weeks. She had no temperature, no cold, was not off her food, had wet nappies and was seemingly otherwise well…all the usual markers you look for to see if your child is sick were absent. But suddenly one evening after finishing her dinner she vomited and her temperature spiked to over 38 degrees. This along with the persistent cough was enough for me to take her straight to A&E.
After an extremely long wait along with doses of paracetamol failing to calm her temperature, she was seen and diagnosed with an upper respiratory infection. She was alert and chatting, looked poorly, but not really sick. The registrar wanted to X-Ray her chest to make sure there was nothing more sinister causing her temperature which may have required antibiotics, but the consultant overruled him and we were sent home. I accepted this as even with my slightly advanced knowledge in this area, I figured it was probably more likely to be a virus that her body needed to fight. As mother to an older child I am well aware that viruses are commonplace in the early years.
A day later, however, everything changed. Suddenly. Like falling off a cliff…
I had already booked a GP appointment that day, just to be safe and get her checked again, but as we arrived at the surgery my baby became floppy, unresponsive and her feet were like ice. The GP called an ambulance immediately and she was rushed into hospital. By this point she was vomiting and crying. The iciness had travelled all the way up her legs to just below her knees. Her skin turned purple and mottled. It was then I realised that this was serious and could be the warning signs of sepsis.
Needless to say I was hysterical on arrival at A&E but was reassured when they quickly jumped into action. The doctors pumped her full of endless fluid to get the blood moving round and circulate her legs to make sure that they did not become seriously injured. They also pumped in antibiotics without awaiting blood results to avoid delay or more damage. It felt like hours that they worked on her, but in truth was probably only about 30 minutes before my daughter's legs became pink and warm and she sat up and demanded "milky"!
Had they not taken such prompt action she could have slipped into septic shock - I dread to think what would have happened. Instead she spent four days in hospital under observation and made an utterly remarkable recovery, with no known organ damage. Ten months on, everything is looking good.
Sadly as the statistics show that is not always the case, which is why it is so important that we raise awareness of the symptoms.
Spotting the signs of Sepsis
Because of my clinical negligence background and the knowledge I had furnished myself with to run the successful sepsis cases I had, I knew the signs of sepsis.
Notwithstanding this, I was pretty self-critical after, wondering if there was any more I could have done to prevent this happening to her. In hindsight, I wish I had insisted on a scan at our A&E attendance.
The time between her looking off colour and becoming deathly sick was so short. Despite their vulnerable appearance, babies are incredibly resilient they fight and fight, but suddenly cannot fight anymore and, as a nurse said to me, they fall off a cliff. There is sometimes only a tiny warning window to act on – but acting on it is vital.
My message for any parent concerned about their child is to be sepsis aware. Know the signs and act as quickly as you can.
Look for things like mottled skin; a temperature over 38 degrees; cold feet or hands; floppiness; unresponsiveness; breathing problems and dry nappies. Most importantly, anything you think is not right – you know your child. You are the best judge.
If your child has been persistently unwell or has even been diagnosed with an infection, monitor them closely and if they do not improve don't be afraid to take them back to your GP or to A&E or speak up if you are worried about sepsis. Hopefully the outcome will be to simply reassure you all is well. Don’t be scared about taking your child more than once if you are worried. My GP tells me they would rather see a well child than miss a sick one. There are no time wasters. Believe me, since this happened I have been to my GP many times with my daughter even when she had nothing more than a common cold– just to be reassured. They understand.
However, if the worst does happen and the symptoms are missed we can help assess whether you have a claim for clinical negligence. When things go wrong this can help make sure that you have access to the right medical care and support to get you or your child back on the often difficult road to recovery. We were one of the lucky ones but sadly there are families out there who are left needing home modifications or specialist medical care as a result of injury or illness worsened by a delayed diagnosis. For more information or confidential advice please get in touch.
*The content in this article does not constitute medical advice. If you have any concerns please contact the NHS Choices website or call the emergency services.
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