PINEHURST, N.C. – Working in the intensive care unit at FirstHealth Moore Regional in Pinehurst, intensivist Russell Miller, M.D., MPH, is hyper-focused on correctly diagnosing patients and offering fast, effective treatments.
He knows from both professional and personal experience that the decisions he and other staff members make can have life-altering effects.
During Sepsis Awareness Month and throughout the year, Dr. Miller also works to educate others about sepsis, which can be a life-threatening medical emergency due to the body’s extreme response to an infection.
“As a doctor who works in the intensive care unit, seeing a loved one experience an illness you know well and have treated is both humbling and troubling,” Miller said.
“Sepsis is often less apparent than stroke or heart attack and requires medical attention to diagnose not just that an infection is present but also that it has become more severe to the point that sepsis is present. In addition, because sepsis can show up in different ways in different people, the march toward severe organ injury can be hard to alter when caught late. Prompt treatment can alter that course.”
In 2010 after undergoing two years of cancer treatment, Miller’s father developed severe weakness, shortness of breath and confusion over the course of a few hours during the Thanksgiving weekend. Miller, who was with his family for the holiday, changed his flights to stay with his father at the hospital.
“I spent much of the next 48 hours at his bedside before he died with and from sepsis, which in his case meant pneumonia and two different types of bloodstream infection that injured his lungs, brain, heart, kidneys and liver,” Miller said.
While he didn’t know it at the time, the experience with his father would inform life-saving decisions he would make nearly a decade later, this time involving his son.
“Nine years later, my teenage son developed a cough, lethargy, low-grade fever and shortness of breath. Rapid diagnosis, including important lab work that indicated his organs were sick, resulted in equally rapid transfer to a children's hospital, where he progressed to respiratory failure resulting in him being placed on a ventilator, or breathing machine, for more than seven days,” Miller recalled. “He was ultimately thought to have a viral pneumonia. Thankfully, without suffering any other organ damage, he made a full recovery, though it took three weeks to do so.”
Miller’s experience with sepsis helps him educate co-workers and families about the risks.
“Early identification of possible sepsis is best detected by those whom patients meet first and see even more often – nurses. Engaging nurses in identifying and initiating basic work-up for suspected sepsis patients helps patients receive better, appropriate care faster,” Miller said. “In my family's cases, our awareness of features of sepsis helped us recognize potential warning signs. In medicine, we seek improved and more consistent methods for detection and treatment of sepsis, including early, aggressive treatments to prevent progression to more severe illness. And that’s because all lives matter.”
In short, sepsis is the body’s extreme response to an infection and is a life-threatening medical emergency. Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Infections that lead to sepsis most often start in the lung, urinary tract, skin or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure and death. Anyone can get an infection, and almost any infection, including COVID-19, can lead to sepsis.
A person with sepsis might have one or more of the following signs or symptoms:
- Confusion or disorientation
- High heart rate or a weak pulse
- Fever, shivering or feeling very cold
- Shortness of breath
- Extreme pain or discomfort
- Clammy or sweaty skin
Experts don’t know why some people develop sepsis while others have infection but not sepsis. Take care of chronic illnesses you may have. Remember to wash your hands and pay attention to potential symptoms of sepsis.
“Even before coming to the hospital, awareness that infection of any sort can progress to sepsis is important in the community, among first responders and among family members,” Miller said. “Sepsis is not an easy diagnosis to make at home, unlike some cases of stroke or heart attack; therefore, prompt medical attention is critical, especially when you see progressive weakness, new confusion, worsening shortness of breath or other concerning signs in loved ones.”
To learn more about sepsis, visit the Centers for Disease Control and Prevention website, which includes fact sheets, symptoms to watch for and other education information.