Tag Archives: Life Threatening

What do you do when you know someone is going to die?

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What do you do when you know someone is going to die? I’m not talking about death when it comes at the end of a long protracted illness or a terminal diagnosis. Or the final act at the end of a “good” life, when the body and mind have ultimately given way. I’m talking about when you realize the twenty-five-year-old woman in front of you, who you met five minutes ago, has no idea she will not survive to see another sunrise.

Moonlighting during residency in the ICU of a community hospital, I was summoned to the ED to evaluate a feverish, septic young woman. In his book, Blink, Malcolm Gladwell describes the gut/reflexive first impression we make before our “thinking” brain starts getting in the way of those initial thoughts. Walking into the ER bay, all the warning bells were ringing. The mottling of her skin told me she was in shock. The visible, rapid rise and fall of her chest told me she was working hard to compensate for an acidosis. Her eyes told me she was afraid, and rightfully so. The rapid pulse and low blood pressure were punctuated by red on the monitor up in the corner of the room. She looked sick, but the reality was much worse. I had known her now all of ten seconds. But I didn’t know she was dead. Not just yet.

 

Public Health Officials Struggle To Identify Sepsis Before It Becomes Deadly

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After Rory Staunton fell at the gym and cut his arm in March of 2012, the 12-year-old became feverish and vomited during the night, complaining of a sharp pain in his leg. When his parents called his pediatrician the next day, she wasn’t worried. She said there was a stomach virus going around New York City, and his leg pain was likely due to his fall.

However, she advised his parents, Orlaith and Ciaran Staunton, to take the youngster to the emergency department because he might be dehydrated. There hospital workers did some blood work, gave him fluids and sent him home.

The next day Rory’s pain and fever were worse. His skin was mottled and the tip of his nose turned blue. The Stauntons raced back to the hospital, where he was admitted to intensive care. The diagnosis: septic shock. Rory was fighting a system-wide infection that was turning his skin black and shutting down his organs. On Sunday, four days after he dove for the ball in gym class, Rory died.

“It was frightening to think that something could kill my son so fast and it would be something that I had never heard of,” said Orlaith Staunton.

She’s not alone. Sepsis kills more than 250,000 people every year. People at highest risk are those with weakened immune systems, the very young and elderly, patients with chronic diseases such as diabetes, cancer or kidney disease and those with illnesses such as pneumonia or who use catheters that can cause infections. But it can strike anyone, even a healthy child like Rory.

Sepsis is a body’s overwhelming response to infection. It typically occurs when germs from an infection get into the bloodstream and spread throughout the body. To fight the infection, the body mounts an immune response that may trigger inflammation that damages tissues and interferes with blood flow. That can lead to a drop in blood pressure, potentially causing organ failure and death.