Septic shock is a potentially fatal condition that occurs when sepsis leads to life threatening low blood pressure. Ways of avoiding sepsis include minimizing the risk of infection by having all recommended vaccines and practicing good hand hygiene.

Knowing how to recognize and prevent septic shock is vital.

The body usually responds to an infection by releasing inflammatory substances into the bloodstream. These regulate the immune system to fight the infection.

When the body loses control of this response, it triggers damaging changes to the organs. As a result, they can become dysfunctional or even stop working entirely. This condition is called sepsis.

In the United States, there are an estimated 970,000 sepsis-related hospital admissions annually.

If a person with sepsis has low blood pressure that does not improve with fluid treatment, their body has gone into septic shock. They will need medications called vasopressors to keep their blood pressure high enough to get blood to their organs.

Without this treatment, insufficient blood flow can result in vital organs not getting enough oxygen and beginning to fail.

Both sepsis and septic shock can be fatal. A study of hospital admissions in California found that sepsis contributed to 1 in every 2 to 3 deaths. In addition, a 2016 review reported that in cases associated with septic shock, the mortality rate was around 46.5%.

Septic shock may also lead to life-altering complications. These can include chronic pain, incorrectly functioning organs, and post-traumatic stress disorder.

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There are a few steps that people can take to reduce their risk of developing sepsis and septic shock:

  • Get regular vaccinations against viral infections that may cause sepsis.
  • Practice good hygiene.
  • Care for and clean any open or gaping wounds.
  • Follow medical advice on managing bacterial infections.
  • Treat fungal and parasitic infections as soon as symptoms appear.
  • Control diabetes, if relevant.
  • Avoid smoking.

Hand-washing tips for people with compromised immunity

People with compromised immune function should take extra care when washing their hands.

The following steps can assist in proper hand washing:

  • Remove rings and watches when possible to clean the areas of skin beneath them.
  • Add warm, running water to the skin on the hands and wrists.
  • Lather liquid soap onto the hands, being sure to include the skin between the fingers.
  • Spend 10–15 seconds washing the hands.
  • Use a towel to turn off the tap to prevent recontamination.

Septic shock is a severe illness. People with sepsis and septic shock require hospitalization and immediate treatment.

Studies have shown that even minor delays in treating severe sepsis and septic shock may increase the risk of death.

Doctors use the following medications to treat sepsis and septic shock:

Antibiotics: Treatment should begin within the first hour after diagnosis. The doctor will administer these drugs directly into a vein.

They will usually start treatment with broad-spectrum antibiotics that act against most of the bacteria that could be causing the infection. Once the blood test results have revealed which bacteria is responsible, the doctor will likely switch to a more specific antibiotic.

Vasopressors: These medications are necessary to maintain adequate blood pressure in people with septic shock. A doctor will use these if blood pressure remains too low after a person receives fluids.

Vasopressors work by tightening a patient’s blood vessels. This can increase their blood pressure. If the blood pressure continues to drop with this medication, the situation is a cause for concern.

Corticosteroids: Doctors may administer these anti-inflammatory drugs if a patient’s blood pressure and heart rate continue to be unstable even after receiving fluids and vasopressors.

Reviews suggest that patients with more severe septic shock may benefit more from corticosteroid application. However, researchers concluded that further controlled studies were required to confirm findings.

Additional medications may include insulin to stabilize blood sugar levels and prevent the patient from developing hyperglycemia.

The most common cause of sepsis is a bacterial infection. Sepsis can then lead to septic shock.

When bacteria find their way into the bloodstream, harmful infections might occur. Bacteria can get into the bloodstream through an opening in the skin, such as a cut or burn.

However, some of the most common conditions that can lead to sepsis include pneumonia and infections of the abdominal area, kidneys, and urinary tract.

Fungi and other viruses may also lead to sepsis and septic shock.

The following groups of people have a higher risk for sepsis:

  • those who are under 1 year or over 65 years of age
  • people who have a compromised immune system, such as those who have HIV or are receiving chemotherapy
  • people who are already unwell or have long-term health conditions, such as diabetes, lung disease, or kidney failure
  • individuals with open wounds, injuries, or burns
  • those with implanted medical devices, such as IV catheters or breathing tubes

Symptoms of sepsis may vary from person to person, but early signs and symptoms typically include the following:

Additional symptoms may include:

  • common signs of infection, such as fever, diarrhea, vomiting, or a sore throat
  • decreased urination frequency
  • pale or discolored skin
  • rashes

It is vital to treat sepsis in its early stages before it progresses and becomes septic shock.

Sepsis

An international task force defined sepsis as “a severe, potentially fatal, organic dysfunction caused by an inadequate or dysregulated host response to infection.”

Doctors may use the quick Sepsis Related Organ Failure Assessment (qSOFA) to determine who may be at higher risk of a poor clinical outcome.

A patient will need to meet two of the following three criteria for a doctor to determine this outcome:

  • Low blood pressure: This is a systolic blood pressure of 100 millimeters of mercury (mm Hg) or below.
  • High respiratory rate: A person taking 22 or more breaths per minute has a high respiratory rate.
  • Altered mentation: Mentation is a measure of mental activity. Altered mentation is a rating of less than 15 on the Glasgow coma scale.

While the above may indicate sepsis, a doctor will carry out further tests to confirm a diagnosis.

Septic shock

To receive a diagnosis of septic shock, the individual must meet the criteria for sepsis and further present with low blood pressure and blood lactate levels of more than 2 millimoles per liter. Low blood pressure is often clinically referred to as hypotension.

Medical professionals may find sepsis and septic shock challenging to diagnose due to overlapping symptoms with other conditions, such as organ failure.

Tests that may help a doctor confirm sepsis and septic shock include:

  • Blood cultures: A doctor will draw blood samples from two different sites in the body and test them for signs of infection.
  • Urine tests: If the doctor suspects a urinary tract infection, they may ask for a urine sample to check for bacteria and infection.
  • Wound secretions: The doctor might test a small liquid sample from a wound to help determine the best antibiotic for treatment.
  • Respiratory secretions: If the individual is coughing up mucus, the doctor may test it to confirm what type of germ has caused the infection.

In many patients, the exact site of the infection will not be apparent. In these cases, a doctor can use imaging scans, such as X-rays, CT scans, MRI scans, and ultrasounds to help identify infected areas of the body.

Sepsis and septic shock are life threatening conditions that require urgent medical treatment. Sepsis occurs when substances released to fight infection begin to attack internal tissue and vital organs.

Septic shock can develop as a complication of sepsis if a patient’s blood pressure drops too low. Septic shock is a critical condition and carries a high mortality rate.

Bacterial infections are the most common causes of sepsis. They can originate externally in wounds or as a result of conditions such as pneumonia.

Anyone who suspects that they or someone else may have sepsis or have gone into septic shock should seek emergency care. Early diagnosis and treatment are vital to a good outcome.