Sepsis “The paramedics came and the only thing
they could actually find wrong was low blood sugar, and they said, ‘can you get to your GP? It might be that you’ve got the start of a type two diabetes, not uncommon in a mid to late 50-year-old male’. They didn’t want to take me in. “But, by then, my brother-in-law, who is a
GP, had arrived at home, and my wife (being a pharmacist), pleaded with them to ‘please take him in’. And they did – with no blue light. We went to hospital, and I was sitting in the normal A&E area, as that’s where they wanted me to go. I went into complete septic shock – I went blue, like a dark blue blazer – and that’s where my problems started. I was put into an induced coma.
“My kidneys were failing, and my liver was
packing up. By 2pm that day, just 12 hours after starting to feel unwell, my wife was being told I had a 5% chance of survival. The hospital team were saying that the likelihood would be amputation at the groin and at the shoulder – and nudge, nudge, wink, wink shall we let him go?
...My wife said, ‘no, you’ve got to save him’. “She reached out to everybody she could
think of and found a team in St. Thomas’s who agreed to take me. So, 16 days later, and still in a coma, I was taken to St. Thomas’s, to a superb surgeon who had seen it all before.” The surgeon evaluated the extent of the
gangrene and what could be saved, then on 1 December, he performed quadruple amputations below the lower limbs, which he described as “a benefit” in terms of mobility. “I laid there with these limbs that looked more
like pharaoh’s arms – they were desiccated, they were blackening, they were dry…I knew that these limbs were finished, and they were coming off,” he continued. Lord Mackinlay went on to advocate for
better prosthetics for amputees, noting the disparity between modern treatments for other conditions and “pre-Victorian prosthetics” for amputees.
Need for diagnostics Considering what needs to happen to improve survival, he argued that diagnostics will be key: “We have a variety of blood tests…mine was lactate, which is a good indicator, and there’s CRP, for example. But you are going to throw antibiotics at a patient who is in a septic shock – you’re not going to wait for the culture and the perfect antibiotic in my view. “So, is there a diagnostic test that we need to look for? Is there a biomarker that is the new ‘golden biomarker’, so we can identify sepsis early on? I can see AI could have a real purpose in analysing diagnostic tests – to say, with a 95% confidence rating, this is indicative of sepsis.
If we can get a proper diagnostic test at the right
time...not only is that good for the person, it’s a
good saving for the country and the NHS Lord Craig Mackinlay
That is the real power of AI in medicine. “In addition, is there potential for a home
test, a lateral flow test, a finger prick test? We devoted all that money, effort and time to COVID tests and they developed COVID tests pretty quickly. “So, is there something we could find, to identify and tackle the mass killer [of sepsis] in the UK?”
He went on to talk about antimicrobial
resistance, pointing out that “if we lose that battle, we also lose the battle against sepsis”. He noted that AMR appears to have “dropped down the political agenda” in recent years, and this needs to be addressed. Ultimately, Lord Mackinlay observed that the NHS is getting better at identifying sepsis but there is a need for improvement. “What we need is early-stage recognition within families and friends, so that people can arrive in hospital quickly, get the antibiotics and fluids they need, and hopefully come out of the other side in better shape than I did. That is my new calling. If my work saves someone from sepsis – their life or their limbs – I’d say that is a job well done.
“I’m up for the challenge of working with companies like bioMérieux and others to see if we can get a proper diagnostic test at the right time... “Not only is that good for the person, it’s a good saving for the country and the NHS – because you don’t want too many people like me; seven or eight months in hospital is expensive. Let’s avoid that when we can,” he concluded. CSJ
References 1. Accessed at:
https://www.worldsepsisday. org/sepsisfacts
2. Naghavi, Mohsen et al. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050, The Lancet, Volume 404, Issue 10459, 1199 - 1226
3.
https://rolobotrambles.com/the-paediatric- observation-priority-score-pops/
4. Krockow EM, Patel S, Roland D. Decision Challenges for Managing Acute Paediatric Infections: Implications for Antimicrobial Resistance. Antibiotics (Basel). 2023 Apr 28;12(5):828. doi: 10.3390/antibiotics12050828. PMID: 37237731; PMCID: PMC10215935.
5.
www.isixsigma.com/dictionary/littles-law/ About bioMérieux
bioMérieux provides a complete solution to support AMS initiatives with 80% of its product portfolio dedicated to the fight against AMR. The company’s actionable diagnostics paired with complementary advanced analytics, collaborative services and educational modules, enable clinicians to provide earlier, optimised and data-driven therapy for better patient management and responsible antibiotic use throughout the entire patient care pathway. For further information, including access to the company’s ‘learning lounge’, visit: https://
go.biomerieux.com/ODOT-uk
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