Sepsis: Recognise the warning signs before it’s too late

Sepsis: Recognise the warning signs before it’s too late

When people think of a medical emergency, they often picture dramatic symptoms such as severe bleeding, chest pain or a major accident. However, some life-threatening conditions begin quietly. Sepsis is one of them.

Paramedics see possible sepsis cases far more often than most people realise, especially in older patients, says Alet Reed, Branch Manager at ER24’s Johannesburg North branch. What can begin as a minor infection can quickly become a life-threatening illness, she says.

“Sepsis is very frequently seen in the pre-hospital environment in South Africa, but early warning signs are often subtle, and families sometimes only call for help once the patient has already deteriorated.”

What is sepsis?

Sepsis is not the infection itself, but a life-threatening complication that occurs when the body has an extreme, uncontrolled response to an infection.

“During this response, the immune system releases large amounts of inflammatory chemicals into the bloodstream,” Reed says. “Instead of helping, this disrupts circulation, causes blood vessels to widen and leak, and interferes with oxygen delivery to organs. Without urgent treatment, organ failure can follow.”

It may develop from common infections such as pneumonia, influenza, COVID-19 or urinary tract infections.

How quickly can sepsis become dangerous?

Sepsis progresses unpredictably. Some patients deteriorate within hours, while others worsen over several days.

Reed explains that a person may appear relatively stable, only to rapidly decline. “In certain cases, a patient can move from mild symptoms to a life-threatening condition in less than 24 hours,” she says. “Because early symptoms often resemble flu, dehydration or general fatigue, the condition is often not recognised in time.”

A real-life example

One case Reed remembers clearly involved an elderly woman who was bedridden and lovingly cared for by her family. She had complained only of mild abdominal discomfort the previous day and went to bed in good spirits. The following morning, her family could not wake her.

On assessment, paramedics found a very fast heart rate, low blood pressure, a high temperature, and discoloured urine, which strongly suggested sepsis – most likely caused by a urinary tract infection. Overnight, she had deteriorated from fully conscious to unconscious.

“Sepsis can be so deceiving and hard for non-professionals to see,” Reed says.

Warning signs families should never ignore

If someone has a known or suspected infection, these symptoms need urgent medical attention:

• Fast heart rate
• Fever or abnormally low body temperature
• Confusion or unusual drowsiness
• Severe lethargy or difficulty waking
• Rapid breathing.

In later stages, poor circulation may develop and the skin, especially the hands and feet, may appear cold, pale, bluish or mottled. Reed warns that confusion, unusual sleepiness, and breathing changes are particularly serious warning signs.

Who is most at risk of sepsis?

Although sepsis can affect anyone, some groups are at higher risk:

• Older adults
• People with weakened immune systems
• Those with diabetes
• Those with kidney disease
• Those with chronic wounds or pressure sores.

Common sources include pneumonia, urinary tract infections, infected wounds and pressure ulcers.

What paramedics do for possible sepsis

When sepsis is suspected, paramedics begin immediate supportive care. This includes monitoring vital signs, administering oxygen, providing intravenous fluids and managing fever.

Paramedics also alert the hospital early so staff can prepare for a seriously ill patient. The main treatment – especially antibiotics and other ongoing care – is given at the hospital.

Why early help matters

There is no safe home treatment for sepsis. If you notice the warning signs, call an ambulance straight away.

Reed emphasises that confusion, abnormal breathing, or being unable to wake the patient are medical emergencies requiring urgent care.

Reducing the risk

Sepsis can’t always be prevented, but you can do the following to lower the risk:

• Finish prescribed antibiotics
• Get medical care early for infections
• Keep wounds clean and check them regularly
• Wash your hands often
• Look after your overall health and immune system.

“It’s a potentially fatal condition,” Reed warns. “It’s vital to spot the early signs and get medical help right away, especially for older people.”