Sabrina Burkdoll, an HCA Healthcare registered nurse, has heard the word “sepsis” her entire nursing career. She’s well-versed in the signs and symptoms of the deadly infection. She’s seen people enter the emergency room, clinging for life. She’s witnessed the devastation and mayhem surrounding a sepsis diagnosis for both patients and caregivers. Some patients lose limbs. Some die.
And eight months ago, sepsis became a personal battle for the nurse. Burkdoll was admitted as a patient at her hospital – HCA Healthcare’s Menorah Medical Center – and began the fight for her life.
For nearly a week prior, Burkdoll had snubbed her body’s warning signs that it was shutting down and slowly succumbing to sepsis.
Thanks to an algorithm-driven sepsis diagnostic tool (SPOT), her husband’s advocacy and prompt medical treatment in the emergency room of our Kansas City-based affiliate, Burkdoll is here today to tell her story.
But first – what is sepsis?
Sepsis is a medical emergency that is treated as aggressively as a heart attack or stroke. It’s an extreme, overwhelming response that occurs when a flood of chemicals enter the bloodstream to fight an infection. This triggers massive inflammation and can eventually lead to severe tissue damage, organ failure, septic shock, and death if left untreated.
Time matters with sepsis. Every hour of delayed diagnosis increases the chance of death by four to seven percent.
Sepsis is an “equal opportunity killer”, impacting people of all ages and all levels of health.
Here are some shocking statistics for you:
- One in three patients who die while in a hospital have sepsis.
- In the U.S., at least 1.7 million adults develop sepsis each year
- 270,000 die from sepsis each year
- Sepsis is more deadly than breast cancer, prostate cancer and AIDS combined
A recent survey found that only 12 percent of adults can correctly identify symptoms of sepsis. Sepsis can be difficult to detect, but signs and symptoms typically include:
- Shortness of breath
- High heart rate
- Shivering, fever, or feeling very cold
- Confused, sleepy, difficult to rouse
- Extreme pain or discomfort
- Clammy, pale or discolored skin
Surviving sepsis – day 1
Burkdoll’s saga began last fall. Her husband, Larry, was hospitalized at Menorah Medical for a brush with a pulmonary embolism. “It was a scary time for us,” remembers the nurse. “But, I knew that my Menorah family had him in good hands. My sole focus was making sure that Larry was going to survive and be okay.”
As soon as Larry was released from the hospital, “I jumped right back into work because I was behind,” says Burkdoll.
Burkdoll is a wife, mother, step-mother and grandmother. She remembers “not feeling the best at work, but as a nurse and my family’s caregiver, I’m the glue that holds everyone together. There was no time to be sick.”
Extreme achiness in her shoulders sets in. Burkdoll chalked it up to the stress of work and her husband’s recent hospitalization and convinced herself that resting at home after her shift would solve the pain.
When she walked through her front door, “I was freezing. I’m of menopausal age, so getting cold is something that never happens. My husband and I fight over the thermostat all the time. But, beginning that day, my body felt so incredibly cold.”
After trying to warm up with a hot bath, Burkdoll told her husband that she had overdone it and felt tired, and curled up into a ball on a recliner to rest it off.
The perioperative nurse woke up the next morning cold and achy. Her husband pleaded with her to call in sick. Yet, she put on her scrubs and headed into the hospital for her shift. “On the way to work, my fingers felt so painful wrapped around the steering wheel and I had a hard time grasping it,” said Burkdoll.
Setting her pride aside, “I ended up calling my manager and saying that I was going to swing by the E.R. to get checked out. I told her I’d be right up after that.”
Burkdoll never made it into work that day.
The emergency room determined that she had an elevated temperature and pneumonia. “I did not want to stay in the hospital, so I begged and pleaded with my coworkers to let me go home,” Burkdoll remembers. “I told myself, since I’m a nurse that I could make myself feel better with plenty of water, acetaminophen and my antibiotics.”
Too tired to pick up her prescription medications, Burkdoll headed home to rest. Freezing again, she hopped into a warm bathtub, where things started to get blurry.
In a role reversal, Burkdoll’s worried husband stepped up and started to play nurse. He picked up her medication and started “charting”. He wrote down every time Burkdoll ingested acetaminophen, ibuprofen and antibiotics. He wrote down her temperature, which, would not break a steady 102 degrees.
“To say I felt horrible was an understatement. But, I told myself I was fine. I thought that if I could beat this fever, I’ve got this,” says Burkdoll. She medicated, drank liquids and took warm baths.
“I would have told a patient who was experiencing the same symptoms to go back to the E.R. immediately because their body was in serious trouble,” said Burkdoll. “But, I kept ignoring my symptoms because nurses are the worst patients.”
In and out of an entire day of sleep, Burkdoll only woke to take acetaminophen and ibuprofen. Her fever would not break 102.
Larry continued to chart.
Waking up in the middle of the night feeling absolutely horrible, Burkdoll begged her husband for more acetaminophen.
But, knowing she was way over her dosage limits, Burkdoll’s husband could not be convinced.
“Things got really blurry at that point. I was starting to see gray instead of color. I was crashing hard,” said Burkdoll.
“I’m calling code sepsis”
Care moved fast– multiple labs, I.V.’s, and Burkdoll’s shortness of breath and rapidly dropping blood pressure.
Alerted by SPOT technology, her nurse pronounced, “I’m calling code sepsis.”
Confused, Burkdoll’s husband asked, “What’s sepsis?”
Unaware of the journey ahead of her, Burkdoll uttered, “It means I’m a little sicker that I thought I was.”
Once sepsis is detected, aggressive treatment boosts a patient’s chances of survival. A number of medications may be used to treat sepsis and septic shock including antibiotics and intravenous fluids.
Through intense bouts of headaches, vomiting and diarrhea, Burkdoll is gracious for the compassionate care she received. “From my sepsis coordinator, to the patient care technician (PCT), to my lead nurse, I credit my amazing care team for getting me through. There wasn’t a single person in that hospital that didn’t try to save my life,” says Burkdoll.
Saving Burkdoll was personal for the Menorah Medical Center family. Burkdoll recalls, “I remember as I was vomiting, my PCT, Patrice Robertson, was holding my hair back and putting a rag on my forehead. I looked up at her and she had tears in her eyes.”
Through another pair of tearful eyes, Burkdoll’s nurse told her that everything would be fine with a reassuring “we’re taking care of you.”
Saving grace – HCA Healthcare’s sepsis detecting SPOT technology
Upon E.R. admission, Burkdoll was hooked up to HCA Healthcare’s algorithm-driven technology S-P-O-T (Sepsis Prediction and Optimization of Therapy), which is trained to identify sepsis 18 hours earlier than the best clinicians.
Through intricate algorithms, the technology uses patient vital signs, labs, nursing reports and other data points to identify sepsis and sound the alarm of a “code sepsis”. This quickly alerts care teams to important, often subtle changes in a patient’s condition so they can take appropriate action.
SPOT has not only saved Burkdoll’s life but the lives of 8,000 HCA Healthcare patients.
“As a nurse, I understand sepsis but as a patient I didn’t fully realize what was happening to me and how dire the situation had become,” said Burkdoll. “I am so grateful for the quick response because without it, I’m not sure I would have survived. Speaking from personal experience, SPOT is a life-saving tool, and I know our patients are in better hands because we have it.”
HCA Healthcare uses SPOT to continually analyze and monitor patients in HCA Healthcare hospitals.
“If you or your loved one were in the hospital, what would you want from the perfect clinician? You would want them focused on you, and only you, 24 hours a day. You want them analyzing every new piece of lab data when it is created, and you want them to understand the implications of that data and the relationships between the different pieces of data,” said Dr. Jonathan Perlin, HCA Healthcare’s chief medical officer and president of its clinical services group.
“SPOT monitors all available data every moment of every day, and when combinations of lab data that are consistent with sepsis are created, the system responds by alerting clinicians so they can quickly intervene with potentially life-saving treatment for you or your loved one.”
Because her life was spared as a result of SPOT technology, she wants to share the good news. “I want to advise nurses to not ignore the amazing technology that we have at our fingertips,” she says. “Use technology, embrace it. And, if you don’t have it, find out if there’s a way that you can get it.”
Prior to her sepsis scare, Burkdoll was careful to keep up with her regular exams and checkups and was in great health. “I pay more attention to when I’m sick now. When I’m sick, I reach out,” said Burkdoll.
“It’s so important to get the word out about the signs and symptoms of sepsis. Often, we see patients come in when it’s too late,” Burkdoll said. “You have to take care of your body and recognize signs and symptoms that seem out of place.”
“And, sometimes, you have to reach out and let others take care of you.”
HCA Healthcare earned the 2019 Red Hat Innovator of the Year Award for the deployment of SPOT, linking algorithmic detection with clinical workflow that enables early identification of sepsis. See the Tennessean coverage here.
HCA Healthcare is a learning health system that uses the significant data which are collected from approximately 31 million annual patient care episodes to inform and improve the care provided to patients. HCA Healthcare’s national clinical data warehouse, which receives information from the electronic health record, is the heart of our data ecosystem, providing the ability to aggregate and analyze data streams in real-time and feed tools like SPOT that, in turn, provide actionable information to caregivers.