Organ Failures During Sepsis
What happens to me if a certain organ fails while I am in the hospital?
The lungs are usually the first organ to fail during sepsis. Most septic patients will require mechanical ventilation (MV) which takes over the breathing function of the lungs temporarily. The patient will be intubated, meaning that there will be a large plastic tube fed through the mouth down into the esophagus. The tube is extremely invasive and uncomfortable so the patient is usually sedated. While ventilated the patient cannot eat normally and is instead fed through a tube.
MV can have many negative side effects such as ventilator-associated pneumonia (VAP), deep vein thrombosis and peptic ulcers. Clearing away oral secretions such as phlegm with a special tube can minimize the occurrence of VAP while a drug called heparin is used to prevent deep vein thrombosis and ranitidine can be used to reduce peptic ulcers.
When your kidney fails you will likely be placed on a dialysis machine. When the kidneys are working properly they maintain the body's water and mineral balance. Dialysis, also referred to as hemodialysis, is an artificial replacement for kidneys. Dialysis machines work by filtering out waste and excess water from your blood and returning clean blood to your body.
Life-threatening heart conditions are usually managed with medications. A common class of medications for treating heart conditions are vasopressors which serve to raise blood pressure. A pacemaker (hyperlink) can be used when the heart fails.
If your liver has failed you will likely be placed on a machine that is similar to a kidney dialysis machine. This machine functions to detoxify the blood temporarily replacing the function of the liver.
The intensive care unit (ICU) is where the sickest patients are provided with care and treatment. The ICU is made up of special teams of doctors, nurses, and other staff who specialize in the treatment of critically ill patients. The ICU also provides an environment with a greater ratio of care personnel to patients, ensuring critically ill patients receive the close monitoring that they require. Typically, a specialized critical care nurse will care for one to two patients per shift to provide the full care needed for each patient. The ICU is also equipped with all the necessary life-saving equipment such as ventilators and dialysis machines that are vital to ensure the best chances of recovery.
There are many types of doctors in the ICU who specialize in certain areas:
They are in charge of the overall care of patients in the ICU. An Intensivist is a medical doctor who has undergone additional, specialized training to care for critically ill patients. An intensivist undergoes general medical school as well as having completed training in a specialty such as Internal Medicine, Anesthesia or Surgery before receiving specific training for critically ill patients.
Consultants are doctors from other areas of specialty. They may be used to consult specific cases and provide care in their field of expertise such as infectious disease or surgery.
Critical Care Fellows
Critical Care Fellows are specialist doctors who are now training to become intensivists.
Residents are medical doctors who are completing their specialty training. Residents are supervised and learn from Intensivists and Critical Care Fellows as they assist in caring for ICU patients.
There are many types of nurses in the ICU who specialize in certain areas:
Nurses in the ICU are Registered Nurses (RNs) who have received specialized training in the care of critically ill patients. Each nurse in the ICU cares for one or two patients at a time. This arrangement permits close monitoring.
The Care Facilitator is the nurse in charge of the unit for each shift and is responsible for managing flow and communication in the ICU.
These nurses are responsible for the overall quality of clinical care in the ICU and supervision of nursing personnel.
Other Healthcare Personnel
There are many other types of healthcare personnel in the ICU who specialize in certain areas:
Physiotherapists help with rehabilitating patients. Physiotherapists assess the patient and identify areas that need improvement, then develop a specialized treatment plan of exercises. They are focused on promoting mobility and independent function. Physiotherapy will often start in the hospital by helping them to gain mobility and independence with daily tasks such as sitting up, walking, using the bathroom and washing. As a patient progresses, the physiotherapist will advance their exercise program to ensure continued improvements.
Respiratory Therapists (RTs) work with the ICU team to help patients with their breathing. Their role includes managing the ventilator, the airway, and providing oxygen therapy. A respiratory therapist is also involved in the rehabilitation process for patients in the recovery phase of critical illness. RTs are extremely important for the aid of septic patients whose infection has affected their lungs.
Some hospitals in Canada have a unique mobile critical care team called the RACE team. RACE stands for Rapid Assessment of Critical Events. This team is normally comprised of an intensivist, a critical care nurse, and a respiratory therapist. The RACE team can travel to other parts of the hospital to provide care for patients outside the ICU with rapidly failing health. They come equipped with a mobile cart that has all the necessary equipment to provide care to a patient in distress until the patient can be transported to the ICU.
There is no magic number of days that each patient remains in the hospital or ICU. Each patient varies concerning the severity and the length of recovery time. A study by Hussak and his colleges showed that the average length of time a patient diagnosed with sepsis stays in the hospital is 12 days. It is about 9 days longer than other patients admitted to the hospital for reasons other than sepsis. Patients that are discharged from the ICU are then transferred to the general ward where they continue to recover. The ratio of care personnel to patients is lower in the general wards as these patients are less sick and therefore do not need to be monitored as closely.