Sepsis: the key signs and symptoms which could have saved my brother
When dad-of-one Mark Canning began suffering with sickness and diarrhoea, it was thought he had gastric flu and was advised by his GP to rest and keep his fluid intake up.
But in the days that followed his stomach pains became increasingly severe and he was advised to visit his nearest emergency department.
Despite being a very fit and active individual, who had only recently finished a gym-based triathlon, his condition deteriorated rapidly in hospital and within just five hours of arriving he was in intensive care fighting for his life.
His brother Terence Canning, who was with Mark during the ordeal, recalled: “Mark was able to walk into the hospital at midday. He was diagnosed with a gallstone issue and needed an ultrasound. But he wasn’t taking instructions very well and he seemed very confused, wide-eyed and agitated.
“He was asked a very specific question about his weight - ‘Are you normally this size?’ - to which he replied ‘I’m doing a marathon and I’ve done a triathlon’, which isn’t the answer to that question. For me it was a strange thing to witness, and at the time I didn’t realise the significance of Mark’s confusion.”
It transpired that Mark had sepsis, a condition where the immune system overreacts to an infection or injury. Without swift medical attention it can cause multiple organ failure and death. Any adult may have sepsis if they show any of these six signs:
Slurred speech or confusion
Extreme shivering
Passing no urine (in a day)
Severe breathlessness
It feels like you’re going to die
Skin mottled or discoloured
Terence said: “I had never heard of sepsis and I didn’t know the signs and symptoms, but I know now that confusion is a key sign of infection - and you can only get sepsis if you have an infection. If I’d known that I would have raised that with medical staff.”
While Terence was making a phone call to his mother informing her of his brother’s bad stomach, Mark suffered a cardiac arrest and was rushed to intensive care with multiple organ failure. He was put in an induced coma and was on dialysis which, sadly, his heart was unable to take.
“He went into hospital on the Thursday, and he was dead - at the age of 41 - by the Saturday lunchtime having gone into septic shock,” Terence said. “The impact of it is horrendous. He’s left a wife without a husband and a daughter, who was three at the time, without a father.
“Making a call regarding sepsis is like communicating a horrific car accident. It’s unexpected, unforeseen and not prepared for. Nobody woke up that Thursday thinking Mark would be gone by the Saturday, including him.”
Terence, 50, from Llandaff North, Cardiff, described his big brother Mark as a family man who was the “life and soul of the party”.
“We were very close and lived in each other’s pockets. He had everything to look forward to. He worked hard, loved life and he was everybody’s friend. He put a smile on people’s faces.”
Following Mark’s death, which occurred on June 2, 2012 at a hospital in Lewisham, London, Terence took up a role with The UK Sepsis Trust to try and improve awareness of the condition among the medical profession and the Welsh public. He now works as Head of Communities at the charity.
“If diagnosed and picked up quickly, sepsis is relatively easy to treat,” he explained. “Much like a stroke, time is of the essence, so the longer you leave it the more likely you are of having an adverse outcome.”
Sepsis affects an estimated 245,000 people in the UK each year, claiming around 48,000 lives. Some 40% of sepsis survivors suffer permanent, life-changing after-effects.
Dr Paul Morgan, the sepsis lead for Cardiff and Vale University Health Board, said that while awareness around the signs and symptoms of the condition has improved over the last decade, there was still some way to go.
“People are aware of the term sepsis through lots of well-publicised stories in the media. But it’s one thing to have heard of it and another thing being able to process what that means to you as an individual, or what it means to your family, and what you should be looking out for,” he said.
“One of the biggest problems for both the public and health professionals alike is the fact that symptoms can be quite varied and wide, and are not particularly specific. However, there are things we do look out for.
“Firstly, you have to have evidence of infection to have sepsis, such as having a high temperature. You also have to look out for people slurring their speech as they’re not getting enough oxygen into the brain. They may act as if they’re drunk or have had a stroke.
“We also look for extreme shivering or muscle pain – the sort of thing you might experience if you have a really bad dose of influenza when everything is hurting. Another concerning sign is not passing urine because that suggests the blood flow to the kidneys is not good enough to maintain their normal function.
“We also look out for skin mottling as the blood flow to the skin is not what it would normally be, as well as feeling really short of breath. Again, it’s the sort of thing you might think is a cold or mild chest infection, but it could be something far more serious.”
Dr Morgan said that one of the most important ‘red flags’ of sepsis for health professionals is a low blood pressure as it could be an indication blood isn’t being distributed to the normal parts of the body as it should be.
“Sepsis can happen to anyone at any age, but certain people are more at risk, particularly the very young and the elderly who have concurrent illnesses that affect their general state of health, such as heart problems, chest problems and kidney problems.”
He concluded: “The medical profession has made progress over the past 10 years in identifying and treating sepsis, but there is still a deficit in the adequacy of the response.”
World Sepsis Day takes place on Wednesday, September 13, 2023. To mark the day, Dr Morgan will be manning a stall on the concourse at the University Hospital of Wales to talk more about the condition which claims around 11 million lives globally each year.
For more information about World Sepsis Day and how you can get #SepsisSavvy, please go to The UK Sepsis Trust website here.