Decisions must be the people’s will

The Scottish Patient Safety Programme has identified six key interventions for the early recognition and treatment of Sepsis (severe infection).

This initiative is known as the ‘Sepsis 6 Bundle’. The key intervention is the early administration of appropriate Antibiotic therapy. As a clinician working at the frontline, in an Emergency Department with the highest rate of Sepsis attendances per year in Scotland, I appreciate that the recognition of Sepsis can sometimes be extremely difficult and subtle. The consequence of this failure to recognise Sepsis early, and treat appropriately, is often death. Without wishing to preempt the findings of the Coroner’s inquest, this is sadly what seems to have happened in the tragic case of Savita Halappanavar, who is widely reported in the media to have died as a consequence of an E.coli sepsis precipitated by spontaneous miscarriage.

Early provision of appropriate antibiotic therapy is the treatment required for suspected or evolving Sepsis. When miscarriage proceeds to the stage where it is medically described as ‘inevitable’, then emptying the womb is the required medical intervention with appropriate antibiotic cover, even in the presence of a baby’s heartbeat.