How to Identify Sepsis: What Are the Early Warning Signs?

Sepsis is a dangerous condition that is not well known but can be life-threatening. According to a 2023 survey by the Sepsis Alliance, only 63 percent of Americans were familiar with the term sepsis. Among that group, only 15 percent could identify the most common symptoms. Knowing how to identify sepsis and its symptoms can be lifesaving – know the risks, early warning signs and symptoms, diagnosis and treatment of this medical condition.    

What is Sepsis? 

Sepsis is the body’s extreme response to infection. It is a life-threatening medical emergency. 

“Sepsis happens when an infection you already have triggers a chain reaction throughout your body,” said Melissa Hill, RN, special projects coordinator at Parkwest Medical Center in Knoxville, Tennessee. “Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure or death.” 

How Common is Sepsis? 

Sepsis is more common than most people realize. The Centers for Disease Control and Prevention notes that:  

• Sepsis affects 1.7 million American adults annually. 
• Roughly 350,000 adults who develop sepsis die in the hospital or are discharged to hospice. 
• Sepsis is a leading cause of death in hospitals, and one in three patients who die in a hospital has sepsis. 
• Nearly 90 percent of sepsis cases begin before you are in the hospital. 

Who is at Risk? 

Anyone can develop sepsis, but Hill notes that certain groups are at higher risk. Be aware of elevated risks and know how to identify sepsis in these groups: 

• Infants younger than one year 
• Adults 65 or older 
• People with weakened immune systems
• People with chronic medical conditions, such as: 
  • Diabetes 
  • Cancer
  • Kidney disease
• People with recent severe illness or hospitalization 
• People who have previously had sepsis 

What Causes Sepsis? 

Sepsis is typically caused by bacterial infections, such as staph infections, E. coli and the bacteria that causes strep throat. Viral infections like COVID-19 or the flu can also cause sepsis.  

“If you are dealing with any infection, you should be watching for a potential complication for sepsis,” said Hill. “Infections that lead to sepsis most often start in the lungs, urinary tract, skin or gastrointestinal tract.” 

How to Identify Sepsis Symptoms Early 

Signs of sepsis include: 

• High heart rate or weak pulse 
• Fever, shivering or feeling very cold 
• Confusion or disorientation
• Shortness of breath 
• Extreme pain or discomfort 
• Clammy or sweaty skin 

 To help remember the signs of sepsis, the Sepsis Alliance recommends checking for TIME: 

Persons with mental decline may appear as confused, sleepy or difficult to rouse. Extremely ill person may experience symptoms such as severe pain, discomfort or shortness of breath.

If you suspect sepsis, seek medical help immediately and say you are concerned about sepsis. 

Is Sepsis Contagious? 

Sepsis itself is not contagious, but the infections that cause it can be transmitted from person to person. Practicing good hygiene is important and can help prevent bacterial infections that can lead to sepsis.  

How is Sepsis Diagnosed? 

If a medical provider suspects sepsis, they may conduct blood tests, lab tests and imaging to help confirm the diagnosis. Blood tests can help find evidence of an infection, blood clots, abnormal liver or kidney function, low oxygen levels or electrolyte imbalances. Providers may also test urine, mucus or saliva to look for the source of the infection. Imaging tests, including X-rays, ultrasounds, computerized tomography (CT) scans or magnetic resonance imaging (MRI), can help identify other possible areas where an infection may be present. 

How is Sepsis Treated? 

Treatment depends on your symptoms, age and general health. In addition, factors include how severe the condition is and where in the body the sepsis may be coming from. Antibiotics and fluids are important in reducing the risk of mortality in sepsis patients. Treatment includes: 

• Antibiotics  
• Managing blood flow to organs 
• Stopping the source of the infection 

Many people need oxygen and IV (intravenous) fluids to help get blood flow and oxygen to the organs. You may need to use a breathing machine (ventilator). Some patients may need kidney dialysis. Surgery may be needed to remove tissue damaged by the infection.  

Preventing Sepsis 

Sepsis can best be prevented by reducing your risk of infection. To help prevent sepsis, stay up-to–date on vaccinations, practice good hygiene and seek appropriate medical attention when you have an infection. One of the best ways to prevent infection is to wash your hands often, using soap and clean running water for at least 20 seconds.  

Knowing how to identify sepsis and taking action are other steps in preventing the condition. If you suspect there is a chance of sepsis, get immediate medical attention and tell them you are concerned about sepsis. 

How Covenant Health is Combating Sepsis 

Hill explained that Parkwest Medical Center and Covenant Health are committed to early sepsis identification and response. Covenant Health has implemented a sepsis treatment program called C.A.L.F. to promote sepsis response and increase SEP-1 compliance, a national metric for sepsis care.  

C.A.L.F. stands for: 

• Cultures 
• Antibiotics 
• Lactic 
• Fluids 

As soon as sepsis is suspected, medical staff begin IV fluids, collect and send lactates (a measure of sepsis severity) and take blood samples. Antibiotics are started if an infection is found during the assessment. 

Education is an important part of combatting sepsis. For example, all new nurses at Parkwest undergo a sepsis education session during orientation. In this session, they learn the procedures and expectations for sepsis care in the hospital. During Sepsis Awareness Month in September, extra education sessions for nurses reinforce the importance of knowing how to identify sepsis. 

If you or someone you know is exhibiting symptoms of sepsis, call 911 or seek emergency care at the nearest emergency room.