Our Family’s 2016 Sepsis Story…

• No Criteria to Meet

• No Dashboards

• No Bundles

• No Policy

• Personal Experience

• Today Feelings Return

• Affective Learning!

• See a Face

• Not a Stat

• Why we do what we do.

July 2016 – Saint-Louis-Du-Nord, Haiti Mission Trip

HOME…• Sunday 6pm Home

• Awake for 24 hours

• 8pm Rigors

• 10pm 106. 8 Temp

• Lethargic, Pale & Headache

• 1st Local Emergency Department

• HR >100 & BP >90

• Nausea & Vomiting x1

• Tylenol, Zofran & 2L’s Given

• Labs – WBC 6.2, Lactate 1.9 & Creat 1.01

• Send Out Labs & Blood Culture’s Done

• Sent Home at 4am with Fever of Unknown Origin

• Started c/o of abdominal cramping at D/C

911 CALL REALITY…• “Anna is not OK.”

• Monday 10am calling 2 MD’s

• Temp 103, Diaphoretic, Pale & Weak

• Frequent Bloody Stool

• On Bathroom Floor

• Deteriorating Before my Eyes

• Calling for HELP! 911 Operator waiting…

• 3 Attempts for IV Access

• Ambulance SBP 120 to 90

• Ambulance HR 90 to 130

• How quickly things change in pics…

• Our Battle Began…

ED Assessment & Triage…

• Fluid Resuscitation Continues

• Rash/Discoloration

• Weak & Scared

• More Labs…

• Stool Samples

• E-Coli Source

• 4 Strains/2 Shigella Toxin

• SIRS & SEPSIS

• Admit = YES

• What Unit? ICU vs. Progressive Care?

• Hemodynamics??

FULL DAY #1…

Organ Dysfunction

Severe Sepsis

RRT call for IV access

IV in foot

Lactate = 3.2

WBC = 2.2

Platelets = 118 - 60

PT/INR = 17.4/1.7

D-Dimer = 4.55

Vitamin K

Low Mg, Phos, Ca & Albumin

Not talking to me and only awake for stooling…

Last Pic?

THIS IS REAL…

• MAP 40’s & HR 130’s

• Hemodynamics Borderline

• IVF Rate 400 ml per Hour

• Multiple MD Collaborations

• Antibiotic Decision Making

• Hemolytic Uremic Syndrome Risk

• Brain & Kidney Injury Risk

• MD Hallway Conversation

• “The Next 24 Hours are Very Critical”

• Are you talking to me?

Navigating Family Experience…

Day 3 & Turning the Corner…

• No sleep

• Lots of Stooling… Bristol Stool Scale

• Vital Sign & Monitor Obsession

• Constant I & O

• Continued Fluids & Antibiotics

• Electrolytes IV Supported

• 30 Lb. Fluid Weight Gain

• Quick Turn at Bedside

• SBP 90 to 110 & HR 130 to 90

• I Could Breathe.

• We fought the fight.

Enjoying the Sunshine & Nearing Home…

TO ME SEPSIS BECAME…

• Fast & Scary

• Easily Disguised

• Real

• A Threat to my Child

• Early Recognition…

• “Why were we sent home initially?”

• “Why didn’t I catch it earlier?”

• “Why didn’t they catch it earlier?”

• New Perspective

• When I hear Sepsis I see Anna.

Discharged… Love Nursing so much!“Not about the Fall but all about the RISE.”

FALL 2016 – Still Navigating…Sepsis Post Discharge… Weight Loss & C-Diff PositiveTHANKFUL, BLESSED & GAINING STRENGTH…

From Stooling to Sepsis to Soccer…

LIFE AFTER SEPSIS…2016 - CURRENT

• Fall 2016 West Jessamine Lady Colts State Champs & Anna named Most Valuable Player as a Freshmen Keeper

• Spring 2017 Committed to University of Cincinnati to play Division 1 Soccer

• Fall 2017 West Jessamine State Champs & Anna named MVP as Sophomore

• Fall 2017 Documentary of Anna’s Journey “RISE” Taylor University

• Reunited with Resident & RN

• Fall 2018 named Allstate All American (125 in Nation)

• 2019 Documentary as All American on National Level

Looking Back & Moving Forward…• Not Naïve to think…• A Story with a Different

Ending.• Sepsis Could Have Won.• My life could have been

forever changed.• We MUST be Diligent! • ED Triage, Sepsis, RRT,

Service Excellence, Clinical Education, Discharge Teaching & More…

• “Quality is a race with no finish line!”

• Intro Documentary…

Anna Rexford “RISE”

• https://www.youtube.com/watch?v=OwlOVcY1_mo