The Fatal Five in IDD: How to Prevent Sepsis

Sepsis is potentially a life-threatening medical emergency, which happens when an existing infection triggers a chain reaction throughout the body. It can quickly lead to tissue damage, organ failure, and death if not treated quickly.

By knowing the signs, symptoms, and risk factors of sepsis, you can help your clients avoid infection. But before we dive in, let’s quickly review why sepsis has been included in the Fatal Five.

Why is sepsis one of the Fatal Five?

The mere fact that anyone can contract sepsis is a large reason for its inclusion in the Fatal Five, not to mention its danger. According to the Centers for Disease Control (CDC), approximately 1.7 million adults develop sepsis each year, with 350,000 of them dying from the condition. Though there is no specific timeline, patients can die from sepsis in as little as 12 hours. While sepsis poses a clear danger to many, it has become an even bigger risk factor among people with intellectual and developmental disabilities (IDD).

In fact, a person with IDD is three times more likely to die from sepsis than someone without IDD. But why? For one, some individuals with IDD have difficulty communicating that they don’t feel well. This can lead to the signs of sepsis going unnoticed or, more often, attributed to other, less lethal, illnesses. Additionally, it can prove difficult for individuals with IDD to procure adequate healthcare and preventative screenings that could help diagnose sepsis early on.

Due to these social determinants of health, physicians have placed sepsis in the Fatal Five alongside constipation, seizures, dehydration and aspiration. To help keep your clients safe, let’s review the risk factors for sepsis.

Risk factors

As a direct support professional (DSP), it is important that you know the risk factors for sepsis so you can determine if your client is at risk and take the appropriate steps to mitigate potential exposure to infection.

Some risk factors include:

• Age, specifically people over 65
• Compromised immune systems
• Chronic health conditions such as diabetes, lung disease, cancer, and kidney disease
• People who have had sepsis in the past
• Pregnant women
• People who have poor hygiene or live in an unhealthy environment

While knowing these risk factors is important, you must also know what the signs of sepsis infection look like and the potential complications that can result from it.

Know the signs of sepsis and its complications

Sepsis is hard to diagnose, another reason for its inclusion in the Fatal Five. It happens quickly and can be mistaken for other conditions. Early identification of sepsis is, therefore, critical to control the spread of the infection. If a sepsis case becomes serious, it can lead to septic shock, which causes a person’s blood pressure to drop below a normal level. This, in turn, can cause organ failure.

To help prevent a sepsis infection from becoming serious, it’s important to learn the condition’s signs and symptoms. The following are key signs or symptoms to look out for:

• Fast heart rate or low blood pressure
• Fever, shivering, or feeling cold
• Confusion or disorientation
• Difficulty breathing
• Severe pain or discomfort
• Sweaty or clammy skin

Fortunately, sepsis itself is not contagious and cannot be spread to other people. However, the original infection that caused the sepsis can be spread to others.

How DSPs can help prevent sepsis

The good news is that DSPs can help lower the risk of sepsis. It is important to support the care of any chronic conditions your clients may have, such as diabetes, lung disease, cancer, and kidney disease. It is also important to make sure the person you support gets vaccines as scheduled by a medical professional.

When supporting a person with IDD, you need to:

• Keep cuts and wounds clean and covered until they are healed, unless otherwise directed.
• Know the signs and symptoms of sepsis.
• Know the health history of the person.
• Help the person manage chronic health conditions.
• Encourage good personal hygiene, including handwashing.

If a person you support has an infection that’s not getting better or is getting worse, act quickly. Contact your client’s physician and let them know what is going on. Be sure to describe the symptoms you have seen and share your concerns. You need to explicitly ask, “Could this infection be sepsis?” and whether the person should go the emergency room for medical treatment.

If you believe your client has developed sepsis, a trip to the emergency room is necessary. Sepsis is a medical emergency, but fast treatment and the administration of antibiotics will greatly improve the individual’s chances of survival. Additionally, a person who has sepsis needs the close observation that an intensive care unit can provide.

Fortunately, improvements in medications have increased sepsis survival rates. However, once someone has had sepsis, there is a higher risk that they may get it again. So, you need to make sure you know your client’s medical history and if they’ve been diagnosed with sepsis in the past.

Read more about the Fatal Five

To learn more about the Fatal Five, read our posts on the other Fatal Five conditions:

• What You Need to Know About Seizures
• How Constipation Impacts Health
• Aspiration’s Dangers and Key Interventions
• Dehydration Signs and Risk Factors