Fiona's Deadly Sepsis Started With A Simple Sore Elbow
The first time Fiona Gray came across the word 'sepsis' was through her own Google search, about one month after it almost cost her her life.
It was July 2015, and Gray was slightly run down with a recurring sore throat that doctors had repeatedly diagnosed as a virus.
As she put her 10-month-old daughter to bed one night, Gray hit her elbow on the baby's cot. She gave it a rub and headed to bed, thinking nothing more of it.
"I woke up a couple of hours later and my elbow was badly swollen. It didn't feel right," she told 10 daily.
Within hours, Gray was shivering uncontrollably and her teeth were chattering -- red flags she would later learn were early signs of sepsis, a life-threatening condition when a person's bodily response to infection damages their internal organs.
"My husband took me to the emergency department and I stayed their for 12 hours as staff checked me for a dislocated elbow," she said.
"I didn't hear the word sepsis once."
Gray was told she had bursitis -- a painful inflammation of fluid-filled pads in between her elbow joint -- and would need surgery to check for infection the following day.
As she waited for a bed in the ward, a nurse checked her blood pressure. It was around 60/40 mm Hg (for most adults, a healthy blood pressure is usually less than 120/80 mm Hg).
Gray was in septic shock -- a life-threatening condition that occurs when sepsis leads to dangerously low blood pressure. She had emergency surgery that night, and woke up on a ventilator.
Years later, she is passionate about ensuring others -- including health professionals -- know and can communicate the signs.
"I feel so lucky to be alive, but I feel a sense of responsibility to be a voice for survivors and to help bring about change," she said.
"I almost feel like that's why I have made it through."
She survived -- despite still needing to manage ongoing memory loss, brain fog, fever and chills -- but many don't. At least 5000 Australians die from sepsis each year, but only a small proportion of people know any of its signs.
The authors of a journal article, published on Monday in the Medical Journal of Australia, are calling for a national action plan on sepsis.
Led by Professor Simon Finfer, from the George Institute for Global Health at the University of NSW, the researchers want to raise public awareness and coordinate treatments to "reduce preventable deaths and disability" from the condition.
The article follows a World Health Organisation resolution passed in 2017, co-sponsored by Australia, that recognised sepsis as a global health problem.
It cites current estimates which suggests there are 18,000 episodes of intensive care unit-treated sepsis across the country each year, and at least 5000 deaths. These disproportionately affect the very young, the very old, and Aboriginal and Torres Strait Islander people.
But Finfer told 10 daily that the true extent of the numbers, beyond those which actually reach hospital intensive care units, could be six times higher.
"We may have as many as 100,000 sepsis cases in Australia each year," he said.
"The problem of sepsis will get bigger rather than smaller."
Sepsis can be treated using antibiotics, to fight symptoms including fever, chills, a rapid heart rate or feelings of confusion.
But a recent survey conducted by the Institute found only four in 10 surveyed Australians had heard of sepsis, and only one in seven knew of its signs. Finfer described the condition as a "time-critical medical emergency" and said lack of awareness can lead to life-threatening delays in treatment.
"There’s no magic drug to treat sepsis. The sooner people are given an effective antibiotic against the bacteria , the more likely they are to survive," he said.
"Once someone gets a low blood pressure, every hour of delay in delivering an effective antibiotic results in between a four and eight percent increase in the risk of that person dying."
Finfer said early symptoms of sepsis can be similar to the flu, which can create "challenges" in getting people to recognise they need medical help.
"If people feel sick enough to go to an emergency department and at that time they don’t need to be admitted to hospital, then we would like to see people sent home with instructions to understand if they're getting worse to come straight back," he said.
Before her own experience, Gray, like many, had not heard of sepsis nor known the signs. She said her treatment was "wishy washy" in hospital, and she was constantly met with "puzzled looks".
"They didn't talk to me about it or ask me questions," she said.
Had I know what it was or had some basic information, I could have called out for help more.
Finfer also wants to see improved support services for sepsis survivors, like Gray.
The mother-of-one has since set up a nation-first support network for other survivors.
"I think about this every day ... I've spoken to families who have lost children or people who have lost their limbs," she said.
"Action just isn't happening fast enough."
Finfer wants to see a peak sepsis group recognised by governments to develop guidelines and run national awareness campaigns, along with a national clinical care standard for the condition.
Both he and Gray urged others to know the signs, and know when to ask for help.
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