BS: Appalling deaths from Sepsis

Subject: BS: Appalling deaths from Sepsis
From: Bonzo3legs
Date: 27 Apr 18 - 02:02 PM

37000 people have died from Sepsis in the last year because NHS staff did not spot the symptoms. My wife was lucky when she was on the verge on Good Friday last year when her surgeon spotted it and called anaesthetist and on call staff. She had a debridement of her leg ulcers, massive antibiotics in her veins, blood transfusion and oxygen and luckily she is here to tell the tale!!

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 27 Apr 18 - 03:13 PM

Goodness Bonzo, she certainly went through a lot with all that! (and you too, worrying about her) Thank the Lord her surgeon knew what he was seeing.
Lots of people slip through the net, as you say.
I hope your wife is feeling better now.

Subject: RE: BS: Appalling deaths from Sepsis
From: keberoxu
Date: 27 Apr 18 - 03:28 PM

Is this not what almost -- I said almost, mind -- did for
Norma Waterson Carthy?
She went in hospital for a procedure on one knee,
and the rest is history.
She, too, is lucky to still be with us.

Subject: RE: BS: Appalling deaths from Sepsis
From: Steve Shaw
Date: 27 Apr 18 - 05:17 PM

You simply can't blame all the deaths from sepsis on the NHS staff not spotting the symptoms. That's completely unfair. Sepsis acts fast and some of the earlier symptoms mimic other conditions. Many sepsis victims would quite likely have died in spite of the very best, prompt healthcare.

Subject: RE: BS: Appalling deaths from Sepsis
From: Bonzo3legs
Date: 27 Apr 18 - 06:30 PM

Not once did our GP surgery suggest referral for in-patient intravenous antibiotic treatment when her leg ulcers were seriously infected with Pseudomonas bug on various occasions during 2016 and 2017. It was basically "try this oral antibiotic", which did nothing. On three occasions her vascular surgeon admitted her for heavy courses of the correct intravenous antibiotic treatment which eventually cleared the infection.

Subject: RE: BS: Appalling deaths from Sepsis
From: Jon Freeman
Date: 27 Apr 18 - 06:59 PM

On infections. We got a bit worried with an infection Pip had. It started with a cut from a ring pull tomato tin. She washed the cut but by the next day, we were thinking it didn’t look right. I can’t remember whether it was the same day or the day after but Peter had a local hospital appointment and Pip went with him. The consultant spotted Pip’s hand and told her to go to casualty. Casualty consulted with the Norfolk and Norwich. She was given antibiotic tablets and told that if it got worse, she might need to go the N&N.

Pip was feeling tired when she got home and had a sleep. When she woke up, it was worse and she called 911. After agreeing that Pip couldn’t drive in (and no one else here drives) they said they would arrange an ambulance. It turned out that later needed further approval from the Ambulance authority but that’s by the by. This was about 8pm and the ambulance arrived at 5am. By this time, the swelling had gone 3/4 the way up her upper arm and she had gone to bed.

The ambulance took her straight in and the N&N saw her straight away, putting her on drips. She was in for 4 or 5 days and I know her blood pressure had dropped and that some notes she read also mentioned stage something or other kidney failure. She was pretty exhausted for a week after getting home too.

Subject: RE: BS: Appalling deaths from Sepsis
From: Joe Offer
Date: 27 Apr 18 - 08:48 PM

Yeah, sepsis is really scary. It happens quickly and unexpectedly, from causes that often seem very ordinary. And although it's such a common condition, there's still no sure-fire cure. And since there are so many unknowns, I don't like the idea of blaming medical people when it happens.
But when a medical condition can kill a healthy person in just a few days, it's so hard to accept or understand.
-Joe-

Subject: RE: BS: Appalling deaths from Sepsis
From: Steve Shaw
Date: 27 Apr 18 - 08:52 PM

Cheers, Joe.

Subject: RE: BS: Appalling deaths from Sepsis
From: Rapparee
Date: 27 Apr 18 - 09:15 PM

In 2006 my FIL visited us out here in The West (they lived in Maryland). The night he got home he went to the hospital in an ambulance. Two weeks later he was dead without regaining consciousness. Sepsis, but from where no one knew. (This was in the Washington, DC orbit where there are some very, very good hospitals.)

Subject: RE: BS: Appalling deaths from Sepsis
From: Joe Offer
Date: 28 Apr 18 - 03:23 AM

I had two friends who died from sepsis after stepping on something - one was something in the garden, and the other was broken glass in the shower. Both of these were people at the peak of health, people I thought would never die.
-Joe-

Subject: RE: BS: Appalling deaths from Sepsis
From: Bonzo3legs
Date: 28 Apr 18 - 04:02 AM

In my wife's case, our NHS surgery failed to recognise the possibility of sepsis occurring in her condition in all 3 occasions that she was admitted for intravenous antibiotic bombardment by her private vascular surgeon and Consultant Dermatologist. Even in the private hospital, one or two nurses followed their own rules on dressings and not those properly suited to my wife whose expertise is now legendary!

She must wear compression stockings for the rest of her life to minimise the return of leg ulcers, and devote a couple of hours each day to leg elevation. She is advised not to stand still for more than a few minutes at a time as sh needs to keep her circulation going, so I do all cooking!!!!!

Subject: RE: BS: Appalling deaths from Sepsis
From: Bonzo3legs
Date: 28 Apr 18 - 07:17 AM

So there you go!!!

Subject: RE: BS: Appalling deaths from Sepsis
From: Steve Shaw
Date: 28 Apr 18 - 06:15 PM

So you choose to extrapolate your personal experience to that of the 37000 others. Weird.

Subject: RE: BS: Appalling deaths from Sepsis
From: Howard Jones
Date: 30 Apr 18 - 08:18 AM

There was a recent article on this by The Times' doctor. He recommended asking the question "could this be sepsis?" if presenting with symptoms. These can be mistaken for other conditions, so it is worth putting the idea in health professionals' minds.

Subject: RE: BS: Appalling deaths from Sepsis
From: keberoxu
Date: 01 May 18 - 02:31 PM

I've never witnessed this firsthand.
Once I participated in a grieving-process group.
A newly-widowed woman told her story.
Her healthy husband had gone in hospital for a routine procedure,
septic shock developed,
and he was dead within a month.

The poor woman was numb. Everyone was telling her -- she confessed to us --
that she was taking it so well not to be overcome with emotion;
when in fact she could not feel anything.
Nor could she eat well; and when she actually could sleep, which was rare,
the nightmares came.

She lamented to us that she could recall no memories of the dear husband she had lived with,
and was detached from recognizing the old photos and so on;
all she could recall was the ordeal in hospital.
The last she saw of her husband's remains,
they were already in a bag -- the sepsis had progressed that far.

With the right kind of support and attention,
some of it private and away from the whole group of participants,
the widow managed to get unstuck, without becoming unglued.
Last I saw her share with the whole group,
she could now connect to memories of the man she loved.
The memories had never gone away,
she had only frozen up inside and lost her connection to her feelings.

So she was extremely vulnerable, but no longer trapped within herself.
That was decades ago and I have never forgotten it.

Subject: RE: BS: Appalling deaths from Sepsis
From: Jack Campin
Date: 01 May 18 - 03:55 PM

Working with second hand books, I can never resist flipping through the medical ones. Today's disease I'd never heard of: Fournier's gangrene of the scrotum. Some the delays described in this thread would be certain death.

Subject: RE: BS: Appalling deaths from Sepsis
From: Bonzo3legs
Date: 01 May 18 - 05:54 PM

Reminds me of "old Scrotum the wrinkled retainer" in Sir Henry at Rawlinson End!

Subject: RE: BS: Appalling deaths from Sepsis
From: punkfolkrocker
Date: 02 May 18 - 12:27 AM

When I was about 10, one of my mates the same age
had an accident climbing a rusty wire fence...

It was agony for him.. and hilarious for the rest of us...

I can't remember the details now.. but the hospital did manage to sew his sack back together...

His name was Neil.. after that we called him Nelly... hah.. primary school sense of humour...

[actually, this is the first time I've thought of this in decades...
it's proper cheered me up...]

Subject: RE: BS: Appalling deaths from Sepsis
From: Joe Offer
Date: 02 May 18 - 02:16 AM

PFR: Ouch!!!

Subject: RE: BS: Appalling deaths from Sepsis
From: punkfolkrocker
Date: 02 May 18 - 07:48 AM

My primary school mate would have definitely needed a tetanus injection...!!!

[all together now... "it's only a tiny prick"...]

Subject: RE: BS: Appalling deaths from Sepsis
From: Dave the Gnome
Date: 02 May 18 - 07:52 AM

No, nurse. I said prick his boil...

I've seen saucy postcards as well :-)

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 02 May 18 - 08:20 AM

Hahahaha! This reminds me of a visit I made to the dentist a long time ago. (I'm terrified of the blooming dentist's) He was about to give me an injection in my gum (gaaaaaah!) and said those famous words, "Now you're only going to feel a small prick." I replied, "How very disappointing. I prefer large pricks actually." I don't know what had got into me - sheer terror I expect. He roared with laughter. I was absolutely bright red with embarrassment.

Subject: RE: BS: Appalling deaths from Sepsis
From: Bonzo3legs
Date: 02 May 18 - 09:10 AM

Our dentist always sprays a little jollup on the gum first so the injection is not felt at all.

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 02 May 18 - 09:17 AM

I have sedation nowadays. I only feel 'a small prick' in my arm while they attach the sedation line. When I wake up I have no recollection at all of the procedure. I'm a big baby I know, but spiders and dentists are my utter terrors.

Subject: RE: BS: Appalling deaths from Sepsis
From: Jack Campin
Date: 02 May 18 - 10:43 AM

...and circling back to the topic: some spider bites can cause sepsis. I have seen someone with a six-inch-long mass of black scab on her arm from touching a floral bouquet (in Amsterdam, dunno if we get the same sort of spiders here).

Whatever the cause, if it looks like you're getting it you need to be in A&E immediately if not sooner and no buts.

Subject: RE: BS: Appalling deaths from Sepsis
From: Jon Freeman
Date: 02 May 18 - 10:53 AM

Other countries but I think brother in Oz got a tick bite that turned nasty very quickly.

I suppose one thing with some of these things is that, whereas the degree of severity might not be realised, something like Pip's infection from the tomato tin do carry quite obvious symptoms. I gather that sepsis can be rather more subtle.

Subject: RE: BS: Appalling deaths from Sepsis
From: Dave the Gnome
Date: 02 May 18 - 10:54 AM

I got a bite on the back of my hand while on the walls at York a few weeks back. I was quite worried about it for a while but while I can still see the site of the wound (just a small prick. Again) There seems to be no lasting effects. It was possibly some sort of tick but what it was in York centre I cannot imagine!

Subject: RE: BS: Appalling deaths from Sepsis
From: Jack Campin
Date: 02 May 18 - 02:06 PM

Major effects of tick bites:

- Lyme disease (watch for a spreading circular rash that develops over a few days or weeks)

- Eastern European encephalitis (not found in the UK yet as far as I know)

Lyme disease is a rapidly worsening problem, but can be treated by antibiotics if you get it dealt with early. Ignore it for months and you've got it for life. Eastern European encephalitis won't usually cause serious damage but it's untreatable. It can be immunized against.

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 02 May 18 - 02:56 PM

Many years ago I was bitten by a tick. We had lovely fallow deer which came into our garden from the fields, and our cats often picked up their ticks in their fur. One attached itself to my leg. I didn't notice it for a few hours. I just pulled it off, but the tell-tale 'bullseye' circular rash sent me to the doctor, and I was given strong antibiotics. He said it could have become chronic Lyme disease (endemic in Norfolk), with many neurological problems. Fortunately I got away with it.

Infection isn't exactly sepsis. The latter is a reaction of the body's immune system to an initial infection, provoking a surge of inflammation which can cause major organs to shut down. Septicaemia doesn't always make itself evident, and symptoms can be missed.

To be fair, it isn't practical for A&E staff to test for simply everything on admission; their resources are stretched and one can't expect them to cover all possibilities, ideal though that would be.

Subject: RE: BS: Appalling deaths from Sepsis
From: Tattie Bogle
Date: 02 May 18 - 07:44 PM

But it's also about what they used to call "clinical acumen" - intense awareness that this wasn't just someone with a very high temperature, but that this person was seriously ill, even if you didn't know at that precise moment what the cause was. That's what medical training is about, being on your guard the whole time so that you don't miss any serious diagnoses, Having seen on more than one occasion how devastatingly fast a case of meningococcal septicaemia can go from from just looking like a bad dose of flu - to death within hours despite heroic efforts to treat the people concerned, I rest my case.

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 03 May 18 - 03:29 AM

I should imagine that a quick and simple blood test could check whether septicaemia was present. Perhaps it should be standard if there are some suspicious symptoms?

Subject: RE: BS: Appalling deaths from Sepsis
From: Tattie Bogle
Date: 03 May 18 - 07:01 AM

A blood test would probably show a very high white cell count and other inflammatory indicators, but it takes longer to identify the responsible bacterium: however as soon as the blood has been taken IV antibiotics and other supportive treatments are started without waiting for results, Any necessary changes can be made once results come through. As I said above, you go on the clinical picture, and treat accordingly.

Subject: RE: BS: Appalling deaths from Sepsis
From: Joe Offer
Date: 05 May 18 - 02:53 AM

How widespread are ticks in the UK? They're all over the place here in the Sierra foothills of California. I get a bite once a year or so. I think my wife gets them more like once a week. So far, no Lyme disease, but it's endemic here.
Joe

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 05 May 18 - 04:14 AM

Ticks are common in many places in UK Joe. For example Exmoor, Dartmoor, North York Moors, Scottish Highlands, Norfolk. Places where there are many deer. (Most deer ticks carry the disease)

The problem is that our deer have no natural predators, and are getting far too numerous. They destroy young trees by nibbling away the bark all round, cause road accidents and their ticks give people Lyme disease. Also in the rutting season, the stags can get very aggressive and attack people. My neighbour ran for his life out in a field where he was hedging, when a large fallow stag charged him! (They have horns!)

People get bitten from ticks attached to their pets, or by walking through long grass in uncultivated areas.
There has been talk of culling the animals by shooting or even by introducing the lynx, which would prey on them. Farmers worry that the lynx would eat their sheep though!

Subject: RE: BS: Appalling deaths from Sepsis
From: punkfolkrocker
Date: 05 May 18 - 08:32 AM

You'd think a simple compensation scheme would appease farmers.
Lynx must surely leave identifiable marks on sheep corpses...
I'm not a big fan of cats..
But real wild cats are magnificent animals...

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 05 May 18 - 09:18 AM

I think lynx are gorgeous pfr. But whenever a new species is introduced, one can't foresee all the consequent imbalances that may occur. They say that lynx wouldn't attack sheep particularly, but would actually go for deer and foxes. Advocates of lynx say this would reduce fox-on-sheep attacks, but foxes beneficially reduce the rabbit and rat population, so it's all connected.

There have been sighting of mysterious 'big cats' here in Norfolk, one was spotted near the garden of our last house. (A large black puma-like creature apparently) And farmers have found remains of sheep corpses with claw-marks on them. The Black Beast of Norfolk!!

Subject: RE: BS: Appalling deaths from Sepsis
From: Roger the Skiffler
Date: 05 May 18 - 12:57 PM

I had a sepsis incident a couple of years ago which NHS online, out-of-hours GP clinic, & ambulance staff failed to diagnose. I was in Intensive Care ward with vital signs dropping before (after X-rays, scans and blood tests) it was diagnosed correctly and iv antibiotics administered. My subsequent blood tests continued to raise concern and it took another scan in another hospital to spot the real cause: basically overlarge prostate blocking tube from kidneys. Surgery solved it. My wife observed Casualty staff trying test after test and consulting several specialists before they nailed it. I'm 100 percent OK now but it was touch and go.
Rts

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 05 May 18 - 01:58 PM

Good gracious Roger, that's terrifying! Glad you're fine now, but it just goes to show that doctors in A&E don't always know 1) what's wrong with someone and 2) what's best to do about it.
If you don't mind my asking, did your kidneys suffer any damage, or are they functioning perfectly well now?

Subject: RE: BS: Appalling deaths from Sepsis
From: Roger the Skiffler
Date: 06 May 18 - 05:38 AM

Thanks for the kind words, Sen. Yes I've recently had my annual meds review and the blood tests show my kidney function is back to normal. Obviously touch and go at one stage. I was "out of it" at the time but very worrying for my wife!
RtS

Subject: RE: BS: Appalling deaths from Sepsis
From: Senoufou
Date: 06 May 18 - 11:46 AM

Glad to hear it Roger. And yes, your poor wife must have been terribly worried.

About five years ago, my husband had the beginnings of sepsis due to an 'acute abdomen'. He was quickly taken to hospital in an ambulance and they discovered he had infected wounds inside his gut where intestinal worms had attached themselves when he was younger (in Africa) He had intravenous antibiotics and stayed for two nights (in a private room - astonishing for the NHS!) They cared for him extremely well and he soon recovered, but I'll never forget the worry.
The little horror was boasting later that TWO very attractive nurses had helped him to the bathroom, pulling his drip along on wheels. He felt like a king!