Treating Sepsis Like the Medical Emergency It Is
For Sandy Peele, getting prompt care from a sepsis team saved her life.
“What do you want us to do if your heart stops?” the nurse asked Sandy Peele. The elementary school teacher was at the vortex of action in the emergency department at The Moses H. Cone Memorial Hospital. Still trying to process what the nurse had just asked, she heard her husband, Terry, say, “I have her health care power of attorney. This woman wants to live.”
Sandy was confused by the scene and more gravely ill than even she knew. Two days earlier, she had left school after coming down with the flu. Today, Alamance County EMS brought her to the hospital as she was having a stroke. The emergency department team found one of her lungs filled with fluid. It was the first clue to the villain behind Sandy’s rapidly deteriorating condition: Sandy had sepsis.
Sepsis is life-threatening and impacts more than a million Americans each year. It occurs when a host of infection-fighting chemicals released by the body turns the tables and begins to overwhelm it. Organs shut down. Mental confusion sets in. Blood clots form. And all of this happens frighteningly fast. One-quarter to half of people with sepsis die. “We thought she had the flu,” Terry said. “She had rebounded and we thought we were winning that war.” But Saturday she took a sudden, dramatic turn for the worse. They were losing that war.
Now in the hospital emergency department, Sandy looked at Terry and told him, “I’m scared.” She wouldn’t remember anything after that for a dozen days.
Sandy was placed in a medically induced coma due to her stroke. But caregivers believed there might be more at work than a stroke, flu and pneumonia.
“Early, aggressive treatment is the key to dealing with sepsis,” says Daniel Feinstein, MD, a Cone Health Medical Group critical care specialist. “Having a high fever, rapid heart rate, low blood pressure and mental confusion are all potential warning signs of sepsis. Fortunately, we have the protocols in place to start treatment even before the lab results come back. With sepsis, you can’t wait.”
The protocols constantly evolve and incorporate the latest medical research and experiences with prior patients. The team of critical care doctors, nurses and pharmacists quickly put Sandy on antibiotics and fluids. The protocols called for additional steps in three hours and more in six. Cone Health’s electronic intensive care unit — a special team that remotely monitors patients using computers and cameras — has its own protocols and joined in the effort to save Sandy.
Sandy soon needed a ventilator to breath. “There was nothing undone or untried,” says Terry.
Sandy Peele at rehabilitation
Feinstein talked with Terry and enrolled Sandy in a clinical trial using a promising medication. It quickly cleared her lungs. Slowly, Sandy turned the corner. After coming out of the coma, she was moved to a rehabilitation unit to begin the long recovery from the stroke likely brought on by blood clots caused by sepsis.
“Ten years ago, no one thought of sepsis as a medical emergency,” says Feinstein. “Today, sepsis is finally being recognized as a medical emergency, just like a heart attack.”
The CDC says most people who get sepsis have a chronic condition. The health agency advises people who have signs of an infection as well as any of the items below to see a doctor and ask if it could be sepsis.
- Shivering, fever or feeling very cold
- Extreme pain or discomfort
- Clammy or sweaty skin
- Confusion or disorientation
- Shortness of breath
- Rapid heart rate
After 32 days in the hospital, Sandy still deals with the shadow of sepsis. She just finished physical therapy at Alamance Regional Medical Center to recover from the stroke. Terry knows there were lots of answered prayers. “We are grateful that she is still here. She is a medical miracle.” They celebrate their 31st wedding anniversary this year.