The New York Times this week profiled Rory Staunton, a 12-year-old boy who died from severe septic shock and whose story underscores ED physicians' struggle to recognize and treat the ailment before it's too late.
Case study: Even minor cut can be tied to infection
According to the Times, Staunton's parents brought him to a New York City ED after he became feverish and began vomiting and experiencing pain his leg; two days earlier, he had cut his arm during a basketball game. Because the symptoms resembled ordinary childhood ailments, physicians gave Staunton fluids, instructed his parents to give him Tylenol, and sent the boy home two hours later.
However, the seemingly simple symptoms indicated a bloodstream infection, and tests completed just after Staunton left the hospital—but never seen by Staunton's family or family physician—offered evidence of that infection. Staunton died three days later of severe septic shock in the ICU.
How hospitals are working to 'Stop Sepsis'
The Times notes that the bacteria linked to Stanton's sepsis, Streptococcus pyogenes, typically causes minor ailments like strep throat—but when it gets into the bloodstream, it can be deadly.
"It moves very quickly," Michael Edmond, the chair of infectious diseases at Virginia Commonwealth University told the Times. "The clinical findings early in the infection can be relatively subtle."
As a result, it is imperative that physicians immediately identify an invasive infection "before the cascading damage of sepsis has picked up too much speed," the Times reports. According to one study, for every hour's delay in starting antibiotics after very low blood pressure had set in, the patient survival rate fell by 7.6%.
In order to better identify and provide early treatment for sepsis, the 55-hospital Greater New York Hospital Association in 2010 launched its "STOP sepsis" campaign, which includes strategies to improve communication and patient flow. A screening tool of that campaign requires special attention for all patients presenting with three of a possible eight symptoms.
When tested, Staunton had only two symptoms, although a third symptom emerged as he was being discharged (Dwyer, Times, 7/11).