Sepsis – the syndrome

RRV with blue lights

Sepsis is a life-threatening condition where the body's response to an infection injures its own tissues and organs. It can lead to shock, multiple organ failure and death, especially if not recognised early and treated promptly. Despite advances in modern medicine, sepsis claims 37,000 lives every year in the UK (in comparison, breast cancer claims 8,000 lives a year).

Sepsis may trigger both abnormal clotting and bleeding. It can strike anyone, but is most likely to develop from infection associated with pneumonia, trauma, surgery, burns, or conditions such as cancer and AIDS but can arise from minor injuries or bites, a simple sore throat or UTI. Although the potential to develop sepsis exists for us all, just like anaphylaxis, certain people are more susceptible than others.

Simplified, sepsis represents three distinct stages:

1. Simple uncomplicated sepsis – two or more of the severe immune response syndrome (SIRS) criteria in response to an infection

2. Severe sepsis – the above plus signs of organ dysfunction

3. Septic shock - the above with signs of shock/hypoperfusion and not responding to fluid treatment/challenge

Severe immune systemic inflammatory response syndrome is a serious condition related to systemic inflammation, organ dysfunction, and organ failure. Patients that satisfy the SIRS criteria and have a suspected or proven infection may be diagnosed with sepsis:

  • Temperature <36 or >38.3˚C
  • Heart rate > 90bpm
  • Respiratory rate > 20 min
  • Acutely altered mental status
  • Hyperglycaemia in the absence of diabetes (>7.7mmol/l).

The majority of cases of sepsis are not preventable, but evidence suggests that early recognition and intervention not only improves survival, but also limits organ dysfunction, thereby either eliminating the need for critical care admission or reducing the length of critical care stay.


The administration of paracetamol is not indicated for suspected or actual sepsis patients with a raised body temperature – research has shown that fever is beneficial to the body to help fight infection. If it has been administered prior to arrival on scene, ensure you document this on the patient care record – paracetamol may mask fever.

The administration of benzyl penicillin is not indicated for sepsis patients unless meningococcal septicaemia is suspected. Please review EEAST’s current pre-hospital sepsis screening tool for guidance on the clinical management of adult sepsis patients.

Get sepsis advice on the go

You can download a copy of the screening tool on the Sepsis Trust website.

You may also want to look at the 'surviving sepsis' app that you can download for android and iPhones. Categories covered by the app include:

- diagnostic criteria
- initial resuscitation
- hemodynamic support
- supportive therapy
- paediatric considerations
- Hershey Medical Center bundle

Published 20th July, 2014; sepsis screening tool link updated 25th February, 2016

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