Understanding sepsis: recognising it early and why every hour counts

What sepsis is

When you get an infection, your immune system fights it. In sepsis, that response goes into overdrive and starts injuring the body's own tissues and organs. Blood pressure can fall, organs can begin to fail, and without prompt treatment this can progress to septic shock and death. Sepsis can follow any infection — a chest or urine infection, a skin infection, or an infected wound — and it can affect anyone, though the very young, older adults, and people with weakened immune systems are at higher risk.

The warning signs in adults

There is no single sign, which is what makes sepsis dangerous. UK safety campaigns highlight a cluster to act on: slurred speech or confusion; extreme shivering or muscle pain; passing no urine in a day; severe breathlessness; skin that is mottled, very pale or bluish; and a feeling of "I feel like I might die." Any one of these in someone who is unwell — especially with a known or likely infection — should prompt urgent assessment. A high or very low temperature, a fast heart rate and fast breathing are common, but their absence does not rule sepsis out.

The warning signs in children

In children, act urgently if a child looks mottled, bluish or very pale; is abnormally cold to touch; is breathing very fast; has a rash that does not fade under pressure; has a fit or convulsion; or is very lethargic or difficult to wake. In babies, additional signs include not feeding, repeated vomiting, and not passing urine for many hours. A child who is getting rapidly worse, or who a parent feels is more unwell than ever before, needs emergency assessment — trusting that instinct matters.

Why every hour counts, and how it is treated

In sepsis, the risk of death rises with each hour that effective treatment is delayed, which is why hospitals use rapid "sepsis six" style bundles: giving oxygen, taking blood cultures and bloods, measuring lactate, and giving intravenous antibiotics and fluids urgently, often within the first hour of recognition. Early antibiotics tackle the source infection while fluids and monitoring support the circulation. Some people need intensive care. The single most important factor a member of the public can influence is speed of recognition — seeking help early and asking directly, "could this be sepsis?"