The Power of Bacteria and the Small Beginnings of Sepsis

 

Roman Wachter thought he had a pesky tooth infection. It would flare up now and then, but each time the pain would subside within a few days. At 32 years old, Roman was healthy and athletic. He didn’t rush to see a physician. He never imagined a toothache would turn into something that put his life in peril. But that it did, placing him in the hospital for a harrowing seven weeks.

 

Tegan McCloud, Roman Wachter, and Dr. Jeffrey Fried

 

Roman’s girlfriend, Tegan McCloud, arrived home from work on February 4, 2013, to find him in severe pain, barely able to talk. “His throat was so swollen I could hardly see his neck,” Tegan says, recalling how alarmed she felt. “I knew right then he needed to get to the hospital.”

 

Tegan and her mom rushed Roman to Santa Barbara Cottage Hospital’s Emergency Department. He was declining quickly and losing alertness. The medical team in the ED recognized signs of septic shock. They took immediate action, administering intravenous fluids and antibiotics in an attempt to stop the dangerous spiral of organ failure happening in Roman’s body.

 

Roman had severe infection of soft tissue in his jaw (Ludwig’s angina) and the bacteria had spread into his chest cavity. Surgeons extracted five teeth and inserted multiple tubes to drain infected fluid around his lungs.

 

Bacterial infections can strike anyone, even the young and healthy, so it’s important to be diligent about recognizing and responding to signs of potential infection.

 

Roman’s lungs and airway were so compromised that doctors had to perform a tracheostomy and use a mechanical ventilator to help him breathe. They placed him in a medically induced coma to facilitate breathing on the ventilator and continued aggressive treatment. Diagnostic tests revealed that Roman had suffered other complications of the infection, including septic arterial embolism in his brain — tiny lesions likely caused by small infected clots.

 

“Sepsis is potentially fatal in a very short amount of time,” says Dr. Jeffrey Fried, who is credited with establishing life-saving sepsis protocols at Cottage. “For every hour of delay in beginning antibiotic treatment there is a 7.5 percent decrease in survival rates.

 

“If Tegan hadn’t gotten Roman to the hospital when she did, his organs would’ve shut down completely, and possibly irreversibly. It’s why our medical team is trained to recognize the signs of sepsis and initiate a sequence of rapid responses. That’s exactly what happened when Roman arrived in our emergency department.

 

“Cottage has been working on sepsis protocol longer than most hospitals. We’ve been at this a long time. I think that’s why our survival rates are so good.” 

 

What is Sepsis? >>

 

Most bacteria won’t hurt you.

 

Though too tiny to be seen with the naked eye, bacteria are found in and around every living thing. In fact, many types have beneficial roles such as helping the body to digest food, destroy disease and absorb vitamins. The ones that can wreak havoc on the body are the other one percent, those infectious bacteria that release toxins and damage tissue.

 

Cottage Health System is diligent in working to battle these harmful bacteria, educating staff and visitors in safe hygiene and implementing infection control measures to pre- vent dangerous germs from spread- ing to patients in our hospitals.

 

For patients who arrive at our hospitals with bacteria battling their bodies, specialists at Cottage continually analyze and improve diagnosis and treatment protocols to save lives.

 

Preventing infection is the best way to prevent sepsis.

 

Washing your hands is the first step toward preventing the spread of infection every day.

 

Cottage is committed to preventing infection and providing the best care to our patients. “We’re getting better and better at treating infection, and preventing it — our hospital infection rates are some of the lowest in the country, they really are exceptional — but bacteria is out there and we have to maintain constant vigilance. We educate our staff, monitor our progress and review our data daily. We don’t let our guard down,” says Dr. Fried. Find Cottage’s infection data here >>

 


Roman, though, was in severe septic shock. His organs had already begun shutting down by the time he reached the hospital. Doctors were unsure whether he would survive. After a week of intensive treatment and multiple surgeries, they discontinued the sedation that was keeping his body in a coma, but still he did not awaken. Finally, on Valentine’s Day, he opened his eyes and recognized Tegan.

 

“Then I knew. I knew things would be okay,” Tegan says matter-of-factly, “because I know him pretty well. He’s stubborn. If anyone could come out of it, he would. He would get better.”

 

True to Tegan’s prediction, within a week Roman was beginning to walk outside his room, working hard to regain his strength.

 

“Mobilizing patients as early as possible helps their muscles and helps to keep their lungs clear of fluid — key factors that contribute to fewer complications and fewer days in the hospital,” says Paula Gallucci, RN, clinical manager of the medical intensive care unit at SBCH, recalling Roman’s extraordinary effort to walk and explaining the staff’s dedication to the effort. “Past convention was bed rest for the most critical patients, for the duration of their time in critical care units. But our research has shown that it actually helps patients recover faster to have them upright and taking steps as soon as they’re able, even while they may still have a ventilator. It’s a practice that’s not yet implemented in all hospitals because it takes a whole team to help a patient walk with a ventilator. It takes a lot of coordination of resources — respiratory therapy, physical therapy, nurses — everyone has to work together to keep the patient safe.”

 

For the duration of his stay in the hospital, Roman continued to walk and rehabilitate but couldn’t swallow properly. He was discharged with a feeding tube in his stomach to help him maintain nourishment. But Roman was determined to eat. He’d lost 50 pounds during the ordeal.

 

“Two and a half months without food is NOT COOL,” Roman emphasizes.

 

Today Roman is able to eat, though it may take many months for him to regain his strength entirely. From the look of his brain scan, doctors suspect his body had infection for close to a year before it was discovered and resolved.

 

“He has so many surgical scars, on his back and shoulders where tubes were placed. It looks like he was bitten by a shark,” says Tegan. “It’s hard to explain to people that it all started with his tooth.”

 

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