Ep.13 NAEMT Radio - Sepsis with Dr. Karin Molander and Rommie Duckworth

In this edition of NAEMT Radio we welcome Dr. Karin Molander, emergency medicine physician and member Sepsis Alliance board and Rommie Duckworth, MPA, LP, EFO, captain, shift commander, and EMS coordinator for the Ridgefield Fire Department in Connecticut.  Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock.  Our guests discuss all things Sepsis with resident host Rob Lawrence, NAEMT Member and Lighthouse Leadership Mentor.

In a wide-ranging discussion, Dr. Molander and Rom particularly highlight the principle of TIME:

T – Temperature higher or lower.

Your body’s temperature should stay fairly constant, around 98.6 degrees Fahrenheit (37 degrees Celsius), moving up or down a bit depending on your activity, the environment, and time of day. A temperature of 100 degrees Fahrenheit (37.7 degrees Celsius) is considered to be hyperthermia, a fever. When you have an infection, your body’s temperature usually rises as it tries to fight off the bug causing the infection. Interestingly, some people see their body temperature go down (hypothermia) instead of up. This is why any change, high or low, can be a sign of sepsis.

I – Infection – may have signs and symptoms of an infection.

If you have a local infection, like a urinary tract infection, pneumonia, or an infected cut, the signs and symptoms are localized according to the area affected (needing to urinate or burning on urination for a UTI, coughing and chest pain for pneumonia, redness and pus for an infected cut, for example). If the infection has spread or you have a generalized infection, you may develop other signs and symptoms, such as fever, fatigue, pain, etc. Sometimes however, you may have an infection and not know it, and not have any symptoms. Keep this in mind especially if you have recently had surgery or an invasive medical procedure, a break in your skin, or you have been exposed to someone who is ill.

M – Mental decline – confused, sleepy, difficult to rouse.

Sepsis can affect your mental status. Some people, especially the elderly, may not show typical signs of infection. Instead, they may show a sudden change in mental status, becoming confused, or a worsening of dementia and confusion. Sleepiness, often severe, is also a common complaint.

E – Extremely ill – severe pain or discomfort, shortness of breath.

Many sepsis survivors have said that when they were ill, it was the worst they ever felt. It was the worst sore throat, worst abdominal pain, or they felt that they were going to die.

Resources:

https://www.sepsis.org/

Prehospital Sepsis Care Research Update, 2023 https://learn.sepsis.org/products/prehospital-sepsis-care-research-update-2023

About Rom Duckworth

Rommie L. Duckworth, MPA, LP, EFO, is a captain, shift commander, and EMS coordinator for the Ridgefield Fire Department in Connecticut. He is also founder and director of the New England Center for Rescue and Emergency Medicine. Duckworth is a dedicated emergency responder, author, and educator with more than 30 years of experience working in career and volunteer fire departments, hospital healthcare systems, and private emergency medical services.

Duckworth has contributed to the NAEMT AMLS and PHTLS textbooks. He is a 2021 recipient of the NAEMT Presidential Leadership Award for his work on the Lighthouse Leadership Committee, for which he also serves as a mentor. Duckworth is also the recipient of the American Red Cross Hero Award, Sepsis Alliance Hero Award, the EMS10 Innovators Award, and the Western Connecticut Health Network Lifetime Achievement Award.

He is the NAEMT representative to the American College of Surgeons Rural Trauma Advisory Committee, the CT-EMS for Children representative for the Ridgefield Fire Department, and an instructor for EMS, fire, rescue, law enforcement, and dispatch education programs.

He’s the author of "Duckworth on Education," as well as chapters in more than a dozen EMS, fire, rescue, and medical textbooks and over 100 published articles in fire and EMS magazines. He holds positions on other national and international advocacy and advisory boards, where he continues to work for the advancement of emergency services professions.

About Dr Karin Molander

Dr. Molander is an emergency medicine physician with greater than 25 years in clinical care.  She analyzes quality of care and is passionate about patient education. Dr. Molander became involved in the world of sepsis in 2007, initially training intensivists in Early Goal Directed Therapy.  She served on her hospital Sepsis committee from 2009 to 2015.  As chair from 2011 until 2015 she collaborated with fellow Sutter hospitals as they navigated through a new electronic health record and a sepsis initiative serving the critical access hospital to the quaternary care center.   She has served on the Sepsis Alliance board since 2018 and was recently their Chair of the Board of Directors. She co-authored a chapter on Sepsis for the American Medical Life Support textbook for Emergency Medical Services and has an updated edition coming out later this year.  She is currently participating in a yearlong Digital Health Fellowship with the goal of optimizing communication amongst patients and providers.  She has co-launched a website DecipherYourHealth.com and joined the social media bandwagon with educational videos on TikTok, Instagram and YouTube.  A book is in the works.

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