In November, Convatec were delighted to welcome Mary Garthwaite and Helen Lake from the Urology Foundation who presented the Convatec Continence Care webinar on urosepsis: from symptoms to solutions.

Click here to watch the webinar back.

Mary Garthwaite, chair of the Urology Foundation board and former consultant urologist, began by outlining the ways in which urosepsis can be recognised. Up to 30% of all cases of sepsis originate in the urinary tract. In highlighting the importance of recognising and treating sepsis, Mary emphasised that while there are traditionally considered to be three stages of sepsis – sepsis, severe sepsis, and septic shock – that it is important to actually think of four stages, with the fourth being death. People with septic shock are likely to die – the survival rate of this stage of sepsis is about 50% in UK.

The signs or symptoms of urosepsis were outlined as:

• Early or mild – urinary tract infection (UTI) symptoms, pain, general illness, diarrhoea, nausea and vomiting
• More severe – confusion or disorientation, breathing difficulties, circulatory problems, severe muscle pain, decreased urine output

Mary discussed the UK Sepsis Trust's signs of sepsis, which make an easy-to-remember acronym:

• Slurred speech or confusion
• Extreme shivering or muscle pain
• Passing no urine (in a day)
• Severe breathlessness
• It feels like you're going to die
• Skin mottled or discoloured.

She highlighted that there are many potential sources of sepsis in the urinary tract, and outlined the risk factors that may increase the likelihood of developing sepsis, including:

• Those with a reduced or suppressed immune status  
• Those who are older
• Those who are frail  
• Women – have both a higher risk and a higher rate of UTIs
• Those with a history of UTI, kidney stones, or outflow obstruction  
• Those who have recently undergone a urological procedure.  

 
In terms of treating urosepsis, the exact prescription will depend on the patient and the infectious organisms. The aim is to prevent progression to severe sepsis or septic shock – so swift referral to hospital is essential if in the community. These patients may also require escalation to intensive care or the high dependency unit and support of major organ dysfunction.    
 
Helen Lake, UTI Information Nurse at the Urology Foundation, then discussed ways of preventing urosepsis. She emphasised that urology patients can deteriorate quickly, so it is important for nurses to have sepsis on the radar and to know which patients are at increased risk. It is also important to educate and empower patients to notice changes and report them, especially when they are not in hospital. Urosepsis is a urological emergency and it requires an effective team response.
 
Helen concluded that it is important to keep up to date with sepsis training and recommended some online learning courses.