September is Sepsis Awareness Month.

Nikki Medalen, MS, BSN, APHN-BC; Quality Improvement Specialist in North Dakota, has been instrumental in increasing awareness ofNikki Medalen sepsis and the symptoms for early recognition. As an EMT who volunteers in her own rural community, Nikki has first-hand knowledge of the importance of early recognition of sepsis, especially in rural areas where transport times may be 60-90 minutes to the nearest hospital. Nikki’s experiences as an EMT provided valuable insight during the development of tools and training sessions for Great Plains QIN’s sepsis project. As a quality improvement professional, Medalen’s passion to provide sepsis education to EMS providers and community members has ultimately affected the care septic patients receive, which may be life-saving. Medalen is a Sepsis Champion.

Great Plains QIN received special funding to work in one rural geographical location in each state to increase awareness and early recognition of sepsis. Medalen shared her insight on these efforts below:

Q. As a healthcare professional, what is your goal/hope in sepsis prevention/awareness?

A. For the public, my goal would be for all individuals to recognize the combination of a known or suspected infection plus two or more vital signs that are not within normal range as a medical emergency. We put all these heavy criteria on it sometimes, such as temperature greater than 100.4 or less than 96.8, pulse > 90, respiratory rate > 20…but those are hard things to remember if you don’t work with it regularly. But the fact is, if there is an infection plus two or more changes to vital signs the situation is dangerous and it is imperative that the person see a doctor immediately.

My goal for EMS professionals would be that they speak boldly when suspecting sepsis. To have confidence in their assessment and to articulate clearly in their handoff to the ER, “this patient meets SIRS criteria for sepsis.” From that point on it is the doctor’s job to diagnose, but their calling attention to it early could be the difference between life and death for their patients.

Q. In the past two years as we have worked to improve sepsis awareness, where have you experienced or witnessed the most success?

A. I really appreciated the experience of providing the education face-to-face with the EMS squads in the rural areas. These First Responders, EMTs and paramedics are so dedicated and well respected in their communities. They had a hunger for the information. Some shed tears recalling an experience they had with past sepsis patients; some shared their enthusiasm for the tools when they reported back to us that they recognized a sepsis event and the patient survived. Not every person we met was “ready” for the information, or took it as seriously as we wanted them to, but when they have that first sepsis experience, I am confident that they will have the tools they need to confirm the accuracy of their suspicion.

In addition, the North Dakota Living article, was a huge success with feedback from all ages of people. That one article stimulated a lot of conversations within communities and resulted in a lot of feedback to us, both in terms of questions and in invitations to speak to groups.

Q. What is most important for the general public to know about sepsis and its impact?

A. First, that sepsis is deadly and secondly, that there may be long term sequalae among survivors. Some of this impact isn’t known right away, but may show up months later in the form of anxiety, depression, sleep disturbance including insomnia, nightmare, hallucinations, flashbacks, inability to concentrate, chronic fatigue…aside from the physical symptoms and issues associated with amputations. It is really important that sepsis survivors discuss these things regularly with their provider and make sure that any new providers are aware of their history of sepsis. The resource: has tips for explaining post-sepsis issues to others (doctors, teachers, coaches, daycare workers).

Q. Share your favorite/most valuable sepsis resource[s] or tool and WHY?

A. For every hour that sepsis goes untreated, the risk of death increases 8%. Don’t wait, seek emergency help immediately. Resource: Stoplight Tool

The National Sepsis Alliance’s Sepsis 911 video: I have given the presentations so many times, including this video, and no one ever appears bored  – they are glued once it starts. If we could get everyone to watch this video, our job would be easy.

September is Sepsis Awareness Month. We hope you will join us in promoting sepsis awareness during September. We will continue to share resources, tools and individual stories in the coming weeks. To learn more and to receive future updates, visit our Web site and join the Great Plains Learning and Action Network. #thinksepsis