Lightning Learning: Acute Confusion & Red Flag Sepsis
STOP!
Acute confusion could be a sign of Red Flag Sepsis (RFS), particularly in younger patients.
Delirium in older patients/those with known cognitive impairment is rarely due to RFS and is usually multifactorial (e.g. dehydration, polypharmacy).
If you suspect that a patient has infection combined with acute confusion, the ‘Sepsis Six’ care bundle should be considered as a time-critical intervention.
Following a small audit at our local Adults ED: just 38 out of 65 patients coded as having Red Flag Sepsis had a Sepsis eAssessment completed on Nervecentre.
This showed we are only 58.46% compliant with completing the relevant documentation for RFS.
LOOK
Why does RFS present as acute confusion in some patients?
The brain is the only internal organ not to sit in the core of the body.
When the body enters a state of septic shock, it responds by redirecting blood flow to its core.
The brain does not receive adequate perfusion during this process which leads to brain hypoxaemia.
Signs of brain hypoperfusion or hypoxaemia:
Confusion, drowsiness, slurred speech, agitation, decreased level of consciousness.*
LEARN
For local ED staff we’ve made a video demonstrating how to find & fill out the Sepsis eAssessment on Nervecentre (embedded below).
*To download a free copy of the latest Sepsis Manual follow this link:
- http://bit.ly/sepsismanual (The UK Sepsis Trust)
