Sepsis is the body's overwhelming and life-threatening response to infection which can lead to tissue damage, organ failure, and death.
Listen as Dr. Rafael Deliz, Pulmonologist and Medical Director of Doctors Hospital Intensive Care Unit, explains the importance of recognizing the symptoms of sepsis in it's early stages to get the best treatment possible.
Important Information About Sepsis: What You Need to Know
Featured Speaker:
Rafael Deliz, MD
Dr. Rafael Deliz is a Pulmonologist and the Medical Director of Doctors Hospital Intensive Care Unit. Transcription:
Important Information About Sepsis: What You Need to Know
Melanie Cole (Host): Sepsis is the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death. My guest today is Dr. Rafael Deliz. He’s a Pulmonologist and the Medical Director of Doctor’s Hospital Intensive Care Unit. Welcome to the show, Dr. Deliz. What is, exactly, sepsis?
Dr. Rafael Deliz (Guest): Welcome, yes, sepsis is a – we call it a dysregulated response. Dysregulated means it’s out of control and the body reacts with excessive response to an invasion of an infectious organism like a bacteria, a virus. It’s a high cause of death in the United States, more than even cancer.
Melanie: Dr. Deliz, infections – typically we think of them as something where the body’s immune system jumps into fight. What causes sepsis and what’s the difference between an infection the body does want to fight and something that takes over?
Dr. Deliz: Yes, that’s an interesting question. Some patients, because of their genetics, are predisposed to have the response that is beyond the usual response and those people have a bad reaction to the bacteria in their bodies. They liberate certain substances in the bloodstream -- we call them cytokines -- and these chemical messengers cause damage to the lungs, to the kidneys, to the heart, and it’s an overwhelming process that may cause death. Not everybody has that predisposition, but we don’t know exactly how that happens in each individual person.
Melanie: Tell us about the signs and symptoms of sepsis. If somebody gets an infection does it have to be a big infection that they’ve got in the hospital or could it be as small as something like a cut? What are some of the signs and symptoms that people would know?
Dr. Deliz: Yes, they already got the infection, could be the urinary tract like a urine infection is very common. It could be pneumonia. It could be an appendicitis and a ruptured intestine, so the sources are multiple. Usually, these patients are at home and the things that worry that cause that are a high respiration above 22 per minute. If you’re breathing more than 22 times a minute, that’s a sign of sepsis. If you have dizziness and you’re sweating, and you feel very weak, that’s another sign of sepsis because it may be that you have low blood pressure and that’s another sign of sepsis, low blood pressure. The other sign is altered mental status. When you talk to somebody who has an infection, and he’s talking incoherences [sic], and he doesn’t sound like the person he’s 100% there, that’s a dangerous sign of sepsis. These three signs are the most important signs in the medical literature after review of 1 million medical records in ten years in major institutions in the United States. We have a score to quantify and predict if the patient will be developing sepsis based on the clinical presentation at the emergency room.
Melanie: How emergent is sepsis? If someone thinks that they’re having it, can they drive themselves to the hospital? Do they call 9-1-1 and let them know that they think it might be sepsis? How emergent is this situation?
Dr. Deliz: Yes, it’s an extreme emergency. When you have sepsis, you have to receive an antibiotic within 30 minutes or less. Most of the time we don’t have that time frame, but if you feel that you’re very sick and you have pain in your body, you’re coughing, and you’re dizzy, and you’re breathing very fast, blood pressure is low, you have to call the 9-1-1, and in the hospital, they have to take blood cultures. They have to culture your urine, your phlegm, and start antibiotics immediately because for every hour you delay the treatment the mortality increases 10-5% per hour. If you wait too late at least the unfortunate case of some patients arriving to the hospital, the mortality increases significantly so the earlier you intervene, the higher the success.
Melanie: Is there any way to prevent sepsis, Dr. Deliz?
Dr. Deliz: Yes, the way to prevent sepsis is to have – sometimes you feel sick, and you delay the process. You have to visit your doctor – you feel that you have a fever, you don’t feel okay. It’s not like a common cold. It’s more complicated. You have to give antibiotics earlier in the doctor's office today is something that can be treated as an outpatient. You also have to look at the vaccine – immunizations for influenza, streptococcus -- those are available with your primary doctor. Also, stay away from infections that are contagious. You see in the hospital there are people that visit other sick people, and they have no precautions. They don’t wash their hands or use a mask. Those are basics, washing your hands if you contact a sick person, and cover yourself if you cough. It’s better to cover with your forearm, not your hand, so you don’t transmit the germs in a handshake. Those are things that you have to be looking for to prevent sepsis.
Melanie: In just the last few minutes, Dr. Deliz, what would you like to tell people about the importance of recognizing the symptoms of sepsis for early treatment and the best outcomes?
Dr. Deliz: Well, my recommendation is don’t delay the process. Unfortunately, there are cases I see in the Intensive Care Unit that they don’t survive are the patients that delay the process. They feel sick, and their stubbornness or not going to be in a hospital caused them a serious, life-threatening illness. I will give you an example. If someone has a urine infection and they don’t want to see the doctor, and they don’t have any treatment, that urine infection enters into the bloodstream, and that’s a very dangerous scenario. You have to give many medications to increase the blood pressure. You have to give fluids. It’s a life-threatening condition, so don’t delay the process. That’s my message today, don’t delay the process. If you don’t feel okay, with fever, dizziness, you see your relative is talking incoherently, immediately you have to send the patient to the emergency room.
Melanie: And why should they come to Doctor’s Hospital of Laredo for their care?
Dr. Deliz: At Doctor’s Hospital, we have a sepsis protocol, and we are perfection in this process for the last two years according to the Surviving Sepsis Guidelines according to the Society of Critical Care Medicine. We have very good numbers about sepsis. For example, in the patients that entered the hospital, we have a high percentage of blood cultures and immediate antibiotic use, higher than the others in the nation. In good compliance with the recommendations of the [inaudible] and organizations in this field, we have an Intensive Care Unit with well-trained nurses and staff. We do rounds every day on sepsis patients -- multidisciplinary with every specialty, nursing, respiratory therapy, nutritionists, pharmacy, the medical director. Everybody’s a teamwork trying to make the patient healthier, making him to survive. We are ready for those types of complications.
Melanie: Thank you, so much, Dr. Deliz. That’s very information for the listeners to hear. Thank you so much for being with us today. You’re listening to Doctor’s Hospital Health News with Doctor’s Hospital of Laredo. For more information, you can go to IChooseDoctorsHospital.com, that’s IChooseDoctorsHospital.com. Physicians are independent practitioners who are not employees or agents of Doctor’s Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctor’s Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners including certain members of the hospital medical staff. This is Melanie Cole. Thanks, so much, for listening.
Important Information About Sepsis: What You Need to Know
Melanie Cole (Host): Sepsis is the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death. My guest today is Dr. Rafael Deliz. He’s a Pulmonologist and the Medical Director of Doctor’s Hospital Intensive Care Unit. Welcome to the show, Dr. Deliz. What is, exactly, sepsis?
Dr. Rafael Deliz (Guest): Welcome, yes, sepsis is a – we call it a dysregulated response. Dysregulated means it’s out of control and the body reacts with excessive response to an invasion of an infectious organism like a bacteria, a virus. It’s a high cause of death in the United States, more than even cancer.
Melanie: Dr. Deliz, infections – typically we think of them as something where the body’s immune system jumps into fight. What causes sepsis and what’s the difference between an infection the body does want to fight and something that takes over?
Dr. Deliz: Yes, that’s an interesting question. Some patients, because of their genetics, are predisposed to have the response that is beyond the usual response and those people have a bad reaction to the bacteria in their bodies. They liberate certain substances in the bloodstream -- we call them cytokines -- and these chemical messengers cause damage to the lungs, to the kidneys, to the heart, and it’s an overwhelming process that may cause death. Not everybody has that predisposition, but we don’t know exactly how that happens in each individual person.
Melanie: Tell us about the signs and symptoms of sepsis. If somebody gets an infection does it have to be a big infection that they’ve got in the hospital or could it be as small as something like a cut? What are some of the signs and symptoms that people would know?
Dr. Deliz: Yes, they already got the infection, could be the urinary tract like a urine infection is very common. It could be pneumonia. It could be an appendicitis and a ruptured intestine, so the sources are multiple. Usually, these patients are at home and the things that worry that cause that are a high respiration above 22 per minute. If you’re breathing more than 22 times a minute, that’s a sign of sepsis. If you have dizziness and you’re sweating, and you feel very weak, that’s another sign of sepsis because it may be that you have low blood pressure and that’s another sign of sepsis, low blood pressure. The other sign is altered mental status. When you talk to somebody who has an infection, and he’s talking incoherences [sic], and he doesn’t sound like the person he’s 100% there, that’s a dangerous sign of sepsis. These three signs are the most important signs in the medical literature after review of 1 million medical records in ten years in major institutions in the United States. We have a score to quantify and predict if the patient will be developing sepsis based on the clinical presentation at the emergency room.
Melanie: How emergent is sepsis? If someone thinks that they’re having it, can they drive themselves to the hospital? Do they call 9-1-1 and let them know that they think it might be sepsis? How emergent is this situation?
Dr. Deliz: Yes, it’s an extreme emergency. When you have sepsis, you have to receive an antibiotic within 30 minutes or less. Most of the time we don’t have that time frame, but if you feel that you’re very sick and you have pain in your body, you’re coughing, and you’re dizzy, and you’re breathing very fast, blood pressure is low, you have to call the 9-1-1, and in the hospital, they have to take blood cultures. They have to culture your urine, your phlegm, and start antibiotics immediately because for every hour you delay the treatment the mortality increases 10-5% per hour. If you wait too late at least the unfortunate case of some patients arriving to the hospital, the mortality increases significantly so the earlier you intervene, the higher the success.
Melanie: Is there any way to prevent sepsis, Dr. Deliz?
Dr. Deliz: Yes, the way to prevent sepsis is to have – sometimes you feel sick, and you delay the process. You have to visit your doctor – you feel that you have a fever, you don’t feel okay. It’s not like a common cold. It’s more complicated. You have to give antibiotics earlier in the doctor's office today is something that can be treated as an outpatient. You also have to look at the vaccine – immunizations for influenza, streptococcus -- those are available with your primary doctor. Also, stay away from infections that are contagious. You see in the hospital there are people that visit other sick people, and they have no precautions. They don’t wash their hands or use a mask. Those are basics, washing your hands if you contact a sick person, and cover yourself if you cough. It’s better to cover with your forearm, not your hand, so you don’t transmit the germs in a handshake. Those are things that you have to be looking for to prevent sepsis.
Melanie: In just the last few minutes, Dr. Deliz, what would you like to tell people about the importance of recognizing the symptoms of sepsis for early treatment and the best outcomes?
Dr. Deliz: Well, my recommendation is don’t delay the process. Unfortunately, there are cases I see in the Intensive Care Unit that they don’t survive are the patients that delay the process. They feel sick, and their stubbornness or not going to be in a hospital caused them a serious, life-threatening illness. I will give you an example. If someone has a urine infection and they don’t want to see the doctor, and they don’t have any treatment, that urine infection enters into the bloodstream, and that’s a very dangerous scenario. You have to give many medications to increase the blood pressure. You have to give fluids. It’s a life-threatening condition, so don’t delay the process. That’s my message today, don’t delay the process. If you don’t feel okay, with fever, dizziness, you see your relative is talking incoherently, immediately you have to send the patient to the emergency room.
Melanie: And why should they come to Doctor’s Hospital of Laredo for their care?
Dr. Deliz: At Doctor’s Hospital, we have a sepsis protocol, and we are perfection in this process for the last two years according to the Surviving Sepsis Guidelines according to the Society of Critical Care Medicine. We have very good numbers about sepsis. For example, in the patients that entered the hospital, we have a high percentage of blood cultures and immediate antibiotic use, higher than the others in the nation. In good compliance with the recommendations of the [inaudible] and organizations in this field, we have an Intensive Care Unit with well-trained nurses and staff. We do rounds every day on sepsis patients -- multidisciplinary with every specialty, nursing, respiratory therapy, nutritionists, pharmacy, the medical director. Everybody’s a teamwork trying to make the patient healthier, making him to survive. We are ready for those types of complications.
Melanie: Thank you, so much, Dr. Deliz. That’s very information for the listeners to hear. Thank you so much for being with us today. You’re listening to Doctor’s Hospital Health News with Doctor’s Hospital of Laredo. For more information, you can go to IChooseDoctorsHospital.com, that’s IChooseDoctorsHospital.com. Physicians are independent practitioners who are not employees or agents of Doctor’s Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctor’s Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners including certain members of the hospital medical staff. This is Melanie Cole. Thanks, so much, for listening.