Sepsis is a deadly reaction to infection, occurring when an infection causes the immune system to go into overdrive and damage the body. In England, there is estimated to be 150,000 cases a year, leading to 44,000 deaths. Research shows that one third of these deaths could be avoided by caregivers or health care professionals recognising and treating sepsis cases faster.
Sepsis in children is fortunately rare. However one child each day in the UK still dies from the condition. The presenting signs and symptoms of sepsis in young children are very non-specific, making it challenging to identify – both for parents and medical professionals.
The Health Innovation Network (AHSN for South London) co-designed and produced the mini-series ‘Spotting the Signs of Sepsis’ with and for parents of children under five, in partnership with ASK SNIFF Safety Netting Collaborative, NHS England and UK Sepsis Trust. The aim of the mini-series is to raise awareness of sepsis for clinicians and parents, enabling safer discharge from Emergency Departments (ED) / Accident and Emergency (A&E), and quicker identification and treatment of the condition.
The films can be viewed on NHS Choices and downloaded for free by healthcare organisations wishing to show the films in their clinical settings.
Sepsis can develop rapidly and affect anyone. One third of sepsis-related deaths in the UK could have been avoided had the patient received optimal care. If medical professionals, patients and caregivers are aware of the signs of sepsis, this will facilitate early diagnosis and treatment with antibiotics and other supportive therapies.
- Recently, sepsis has been high on the national and political agenda, with avoidable cases of sepsis and deaths from sepsis achieving high publicity.
- A number of Patient Safety Collaboratives around the country have run sepsis projects, but the majority have focused on adult practice.
- The presenting signs and symptoms of sepsis in young children are very non-specific, which makes it very challenging to identify, for both parents and medical professionals.
- Sepsis has the potential to develop over time. It is therefore expected that there will be occasions when a clinician appropriately sends home a child who subsequently develops sepsis. This is why it is important that parents can recognise the signs and symptoms.
- There is no nationally accepted definition or diagnostic criteria in adults. There is even less consensus existing in sepsis for children. For example, within south London, lead clinicians across seven acute trusts were found to be generally developing their own trust-specific sepsis pathways.
Dr Lauren Fraser, now an Emergency Medicine Consultant at London North West Health Care NHS Trust, chose the project to focus on during her year as a Darzi Fellow at the AHSN. Through contacts made within the AHSN’s Sepsis Community of Practice, she gained support from NHS England’s Cross-system Sepsis Programme Board.
To standardise safety netting advice and raise awareness of the symptoms of paediatric sepsis, three films were co-designed and produced. Footage for the films was captured at St George’s University NHS Foundation Trust, with the ‘fading rash’ clip provided by a team at University of Leeds. Dr Ranj, a popular children’s TV presenter and NHS Doctor, features in the films.
- The content of the ‘Spotting the Signs of Sepsis’ film was sourced from a leaflet produced by UK Sepsis Trust, with ASK SNIFF’s Parent Panel providing vital guidance for the film.
- ‘Caring for children with fever at home’ provides parents of children with fever, who had already been cleared of being at risk of sepsis, advice with caring for their children at home.
- ‘Spotting the Signs of Sepsis: A&E/ED Edition’ was created for parents of children under five being discharged from ED following infection.
Implementation guides were created by the AHSN to help primary care clinicians and emergency departments implement the films in their clinical settings.
- The accompanying hashtag (#spotsepsis) achieved 1.3 million Twitter Impressions from 627 participants across the UK.
- By May 2017, culmative views total over 2.8 million across multiple platforms (Facebook, Twitter, Youtube, NHS Choices) making the cost of the film less than 2p per person viewed.
- Shortlisted for 2018 Patient Safety Awards in the ‘Product or Innovation’ category.
- A subtitled version of ‘Spotting the Signs of Sepsis’ and ‘Caring for Children with Fever at Home’ have been released.
- The A&E/ED edition of the films has been implemented in three south London paediatric emergency departments to date. Digital packs were created to aid implementation of the films in more emergency departments and primary care settings.
- A small number of Emergency Departments outside of London have expressed interest in the film, with one having received a DVD copy.
- Ahead of World Sepsis Day (13 September), ‘Spotting the Signs of Sepsis’ was publicised on Global Sepsis Alliance and World Sepsis Day websites.
- Following promotion of the film on World Sepsis Day, a parent contacted the partnership to inform them that, because of viewing the film on 13 September, she was able to quickly identify sepsis in her daughter and get her to A&E for treatment in the early hours of 14 September. The daughter is recovering.
- The Royal College of General Practitioners (RCGP) have included use of the films in their Sepsis Toolkit.
- The project has been accepted into ‘The Academy of Fabulous Stuff’ on 18 July 2017.
- The film was featured in an article in the August edition of ‘At Home with Lorraine Kelly’.
“Last Wednesday you posted the video with the signs of sepsis, on the Thursday my daughter became ill and if it wasn’t for your video I wouldn’t of (sic) took her to the A&E at 2 in the morning.
“Your video helped me make the right choices for my daughter and helped catch sepsis early. I don’t know who sees this message but I just wanted to say thank you for the video and making awareness.
“This will save lives.”
Promotion of the mini-series will continue, with the hope that more EDs and primary care settings will implement it and signpost parents of children under five towards it.
The film ‘Spotting the Signs of Sepsis’ will shortly form part of the Public Health England Sepsis Online Campaign resources. It’s intended that ‘Spotting the Signs of Sepsis’ will be translated into different languages. ASKSNIFF are planning to use some of the footage in further awareness films.
The films are available for free download. Alternatively, healthcare staff wishing to show the films in their clinical settings can request a USB copy at no cost by emailing [email protected].
Work began in January 2017. The films were released 10 July 2017. Promotion of the mini-series is ongoing.
Jemima Heard, Communications Officer, Health Innovation Network
E: [email protected]
The National Early Warning Score is helping to spot the signs of sepsis and deterioration.