The three stages of sepsis include sepsis, severe sepsis, and septic shock. Sepsis is a life-threatening health condition that is caused by an infection in the body, which triggers severe inflammation in tissues and organs. Without immediate medical attention, the stages of sepsis will usually result in serious physical and mental health complications that lead to organ failure and the eventual death of the patient.
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What Are the Causes of Sepsis?
In medical terminology, sepsis is defined as a serious condition that results from the presence of harmful microorganisms in the blood or tissues. These microorganisms lead to severe infection within the body. The infection leads to a fight or flight response and triggers a chain reaction of both physical and cognitive impairments. Unless sepsis is discovered and treated quickly, the end result for a patient with sepsis is usually septic shock, tissue damage, organ failure, and death.
According to the Centers for Disease Control and Prevention (CDC), sepsis can be caused by viral infections such as COVID-19 or influenza, bacterial infections caused by cuts, wounds, bronchitis, and pneumonia, and fungal infections found in the mouth or lungs, urinary tract, or on the skin. However, CDC records show that infections leading to sepsis most often begin in the gastrointestinal tract, urinary tract, lungs, or on the skin. Records indicate that in 87% of cases, sepsis typically begins before a patient goes to the hospital, and many patients don’t get treated soon enough to survive.
Sepsis can occur from any type of viral, bacterial, or fungal infection within the body that is not properly treated. The longer sepsis goes untreated, the greater the risk of sepsis shock and death from organ failure.
Some of the most common causes of sepsis include:
- Abdominal infections
- Blood poisoning
- Catheter infections
- Respiratory viruses
- Third-degree skin burns
While cases of sepsis usually develop due to a lack of medical treatment for common types of infections, many cases develop in hospital patients suffering from major illnesses, like influenza, kidney disease, or pneumonia, or who are undergoing surgical procedures that require extended hospital stays.
Following surgery, if surgical incisions are not properly cleaned and dressed on a regular basis, infections can develop at wound sites and spread to other parts of the body. If immobile patients are not turned over and moved every few hours by nurses, serious bedsores may develop. In hospitals, staff infections, known as staphylococcus aureus, are a common type of bacterial infection found in patients, and it is resistant to some types of antibiotics, putting the patient at higher risk for serious complications.
Like most medical conditions, the symptoms of sepsis usually vary depending on the stages of sepsis. The most common signs and symptoms of sepsis include:
- Chills and fever
- Breathlessness or difficulty breathing
- High levels of lactic acid in the blood
- Low body temperature (hypothermia)
- Low blood pressure (hypotension)
- Racing heart
Sepsis symptoms such as chronic pain, chills and fever, excess sweating, difficulty breathing, and confusion and disorientation resemble symptoms of other medical conditions which may be less severe. For this reason, seeking immediate medical treatment is essential to get an accurate diagnosis and treatment plan. If you do have sepsis and don’t get treatment right away, your sepsis can progress to a more advanced stage and lead to a variety of serious health conditions including septic shock, multiple organ failure, or even death.
Stages of Sepsis
Sepsis progresses in stages depending on the cause of the sepsis and the severity of its complications on bodily organs and tissues. There are 3 stages of sepsis: 1-sepsis, 2- severe sepsis, and 3- septic shock. As each stage progresses, the patient’s risk factors for life-threatening consequences increase.
Stage 1 – Sepsis
Sepsis is often difficult to identify in its early stages, but doctors look for the following common symptoms that show evidence of the disease during the first stage:
- Bacterial, fungal, or viral infection confirmed through positive blood culture results
- High fever above 101º F
- Low temperature below 96.8º F
- Heart rate above 90 beats per minute
- Rapid breathing rate higher than 20 breaths per minute
To receive a medical diagnosis of sepsis in these early stages, a patient must have at least two of the above symptoms. Getting medical treatment as early as possible increases your chances for a better outcome and survival. When sepsis is caught in stage 1 before it affects vital organs, infections can be treated with antibiotics. Most sepsis patients who are treated in stage 1 make a full recovery.
Stage 2 – Severe Sepsis
The second stage of sepsis, severe sepsis, is typically diagnosed by medical professionals when life-threatening organ dysfunction occurs in a patient. Severe sepsis is usually characterized by the following symptoms or vital signs:
- Abnormal cardiac output or heartbeat
- Acute respiratory distress or difficulty breathing
- Decrease in urine output
- Extreme weakness
- Mental confusion or unconsciousness
To receive a medical diagnosis of sepsis in this stage, a patient must have at least one of the above symptoms. If you test positive for sepsis during stage 1, doctors will also follow up with a test for your urine output factor in stage 2. Doctors note that a diagnosis of severe sepsis also raises the risk of future sepsis infections.
Stage 3 – Septic Shock
Sepsis patients who reach stage 3 are diagnosed with septic shock, the most dangerous of the stages of sepsis. This stage is the most dangerous because it’s commonly associated with severe inflammatory response syndrome. Stage 3 sepsis patients often exhibit low blood pressure and high lactate levels, despite medical intervention and treatment. To ensure adequate blood flow to vital organs, doctors look for a reading of at least 60 mm HG or higher.
Septic shock is often indicated by a severe drop in blood pressure and blood flow, which indicates a life-threatening condition. This is often accompanied by symptoms including severe sleepiness or the inability to stay awake, the inability to stand up, and major changes in mental status such as confusion and disorientation. Progression to septic shock significantly increases the risk of a patient’s death to between 30% and 50%.
As the stages of sepsis advance, health conditions worsen for the patient. In stage 3 of sepsis, blood flow is impaired to the vital organs like the brain, heart, and kidneys, which leads to organ dysfunction. Stage 3 sepsis is also a common cause of abnormal blood clotting that results in burst blood vessels or small blood clots that damage or destroy tissues. This can lead to health complications such as damage to the heart valve, kidney failure, tissue damage or death, permanent lung damage, and permanent brain damage. At this stage, doctors usually perform a sequential organ failure assessment score to quantify the number and severity of failed organs and the patient’s risk of death.
Who Is at the Greatest Risk of Sepsis?
Hospitals, nursing homes, and long-term care facilities encounter large numbers of sepsis patients. While some patients are admitted with sepsis, other patients develop sepsis while in the facility, often due to improper or inadequate medical treatment by the nursing staff or caregivers. A medical malpractice attorney often handles cases focused on sepsis and other health conditions caused by the negligent actions of doctors, nurses, and other medical professionals.
While anyone can develop sepsis, some people are at higher risk of getting complications from the illness. People in the higher-risk group include:
- Adults 65 years of age or older
- People with chronic medical conditions
- People with weakened immune systems
- People in the hospital for severe illness
- Previous sepsis survivors
- Infants and children younger than one-year-old
Patients in nursing homes and long-term care facilities fit most of the conditions for a high risk of getting sepsis. According to the CDC, nursing home and long-term care patients make up a significant percentage of adults who develop sepsis and have a previous health condition that increases their risk factors for sepsis and sepsis shock. Most of these patients are over the age of 65 with chronic health conditions such as cancer, diabetes, kidney disease, respiratory illness, weakened immune systems, mobility issues, and a history of hospitalizations and surgical procedures. There are many reports of suspicious deaths in nursing homes that are linked to improper patient care, patient neglect, patient abuse, and other forms of mistreatment that cause physical and mental harm.
When nursing home patients develop bed sores, family members often ask an attorney, “can you sue a nursing home for bed sores?” If the patient’s bedsores are linked to negligent actions of the nursing home facility, the patient’s nurses, or the patient’s caregivers, they can be sued for causing the condition.
Infants and Children
Infants and children younger than one-year-old are also at high risk for sepsis and sepsis shock, especially if they have chronic health conditions, weakened immune systems, and breathing problems. Exposure to invasive devices like breathing tubes, equipment used to administer intravenous (IV) fluids, and catheters create a higher risk factor for developing sepsis.
Newborns and pre-term babies can also develop sepsis easier from bacterial, viral, and fungal infections and blood poisoning because their immune systems are not yet developed. Neonatal sepsis occurs when a baby gets an infection in the blood within the first month of their life. Sepsis in newborns is classified depending on the timing of the disorder. Early-onset sepsis is contracted during birth, while late-onset sepsis is contracted after birth. This timing is critical because it helps the doctor determine the best type of sepsis treatment for the baby.
Pre-term babies and babies born with low birth weight have a higher risk of late-onset sepsis. This increased risk is due to the lack of a developed immune system, which prevents the baby’s ability to fight off sepsis. The signs of sepsis in a newborn may be subtle and unspecific such as abdominal pain, apnea or breathing problems, diarrhea and vomiting, low body temperature, fever, seizures, and pale skin. Sepsis in newborns is one of the leading causes of infant death, however, when it’s detected early with fast treatment, infants usually recover completely and do not have related health problems.