“Peter came home from work one day complaining that his foot hurt, he thought he might have injured it. He had a small scrape from a week prior and said when he bumped it, his whole foot started to ache, almost like a sprain. Late that evening, he woke up complaining of more pain, and about an hour later became violently sick. This continued into the morning, when Peter and his partner decided to seek medical attention. Peter inquired about his foot injury, as the scrape on his foot had grown and a small black spot had developed next to it. But the staff assured him the cut was unrelated and suspected he had a stomach bug, sending him home with a prescription for anti nausea medication. During the next 36 hours, the condition of his scrape became much worse. Peter was feverish, had no appetite, and was unable to stay awake for more than an hour throughout most of the day, so weak he could hardly stand. He and his partner decided to seek further emergency care. When they arrived at the hospital, a team of staff evaluated Peter and determined the severity of his infection on his foot was critical. Peter had multi organ failure including liver and kidney, his blood pressure was dangerously low, and he experienced near heart failure. The medical team informed Peter that he had sepsis, and he needed surgery immediately” (Alicia, September 16^th, 2019).

If Peter, his partner, or the staff had known more about sepsis, his illness could have been addressed days before it escalated so drastically. Unfortunately, the process of diagnosing sepsis is often similar to Peter’s story. The symptoms of sepsis are subtle and often confused with symptoms of other illnesses, like the first medical team that assumed Peter had a stomach bug. There is a lack of education and awareness regarding sepsis, due to limited identification and management resources. In addition, there is no specialty or department that ‘owns’ sepsis (Sepsis, 2019). Occupational therapists are able to help bridge that gap

As occupational therapists, we have a unique relationship with our clients. We spend more one-on-one time with our patients/clients than any other member of the healthcare team. There are many subtle symptoms of sepsis that only someone who spends a fair amount of time with the individuals might pick up on. For example, Iindividuala may feel hotter or colder than usual, have unusual pain or discomfort, the color of their skin might change, they may feel more tired than usual or slightly confused, and their breathing may become more shallow (Sepsis, 2019). Each symptom presented during the initial stages of sepsis is difficult to assess without an in depth, holistic view of the client’s baseline and an understanding of sepsis.

Peter’s original warning signs were not recognized by the medical staff who, like many other health professionals, did not have proper sepsis training. Because of this, Peter required surgery, extensive antibiotic treatment, three days in the ICU, and an additional week long hospital stay. Peter eventually went home with a pic line for continued antibiotics and required daily wound care, but most importantly Peter survived. Unlike the estimated 270,000 people in the United States that die from sepsis every year, or those who are left with permanent physical and/or cognitive damage, Peter beat the odds, and is healthy and happy. He went back to work full time and was granted the opportunity to ask his partner to marry him. They have since been married, his now wife is graduating with her doctorate degree, and they are expecting their first child, a baby girl.

Bottom line…watch for subtle changes that may be signs of early sepsis and if you suspect sepsis, speak up, and tell your patients and clients to speak up. In the end, Peter was lucky. Occupational therapists can help their clients avoid the complications that Peter went through because of sepsis.

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