Understanding Sepsis: Spot It Early, Save Lives
Last updated: August 2025. This article has been refreshed to include current UK guidance and recent international evidence (PMC 11221400).
Sepsis is a life-threatening reaction to infection. It happens when the body’s immune system overreacts, causing widespread inflammation and damaging its own tissues and organs. Without rapid recognition and treatment, sepsis can quickly progress to septic shock, multi-organ failure and death.
In the UK, the UK Sepsis Trust estimates that around 245,000 people develop sepsis each year and nearly 48,000 deaths are linked to it. Official figures from the Office for National Statistics (ONS) reported 26,203 sepsis-related deaths in England and Wales in 2023. While methodologies differ, the scale of the problem is clear: sepsis is a major patient safety issue that demands better awareness.
A recent systematic review published internationally on PubMed Central (PMC 11221400) reinforces what UK guidance already tells us: early recognition and prompt escalation save lives.
Why sepsis awareness matters for care staff
Many assume first aid or basic life support training covers sepsis. In reality, generic first aid courses rarely include it. Paediatric first aid may touch on meningitis, but adult sepsis is often overlooked. This leaves a critical gap, especially for care and support staff, who are often the very first to notice when someone in their care starts to deteriorate.
NICE guidance (NG51) is clear: all healthcare staff, including those in care homes, should be trained to recognise sepsis and know local escalation pathways.
Care workers are not expected to diagnose sepsis. But they are vital in spotting the early warning signs, trusting their instincts and escalating concerns quickly. With the right face-to-face, clinician-led training, carers can also build confidence in taking a full set of observations, recognising both soft signs and red flags, and knowing how to communicate their concerns clearly to NHS professionals.
NEWS2: the language of deterioration
In the NHS, the National Early Warning Score (NEWS2) is the standard system for identifying deteriorating patients. It is endorsed across acute hospitals and ambulance services.
(The Royal College of Nursing, n.d.)
(Royal College of Physicians, 2017)
NEWS2 includes:
Respiratory rate
Oxygen saturation (SpO₂)
Systolic blood pressure
Pulse rate
Level of consciousness (Alert, NEW Confusion, Voice, Pain, Unresponsive)
Temperature
While care staff may not have been expected to calculate scores in the past, our Sepsis Training for Care Staff gives them the skills and confidence to do so. By learning to take vital signs and calculate a NEWS2 score in a supported environment, carers gain a shared language with NHS staff. This means they can hand over concerns with clarity and confidence, helping ambulance crews and hospital teams act without delay.
Closing the training gap
At NR Medical Training, we developed a dedicated Sepsis Recognition and Escalation course for care staff. It aligns with NICE NG51 and uses UK Sepsis Trust resources to build confidence in recognising red flags and communicating deterioration.
The focus is practical, not theoretical. It helps carers recognise what is serious and act fast. Because the training is delivered face-to-face by experienced clinicians, staff leave not only more knowledgeable, but also more confident in their own ability to take vital signs, calculate a NEWS2 score and escalate concerns. That confidence can make all the difference when caring for the most vulnerable people in our communities.
“As a paramedic, I’ve seen first-hand how quickly sepsis can overwhelm someone who looked relatively well only hours before. Care staff are often the very first to notice when something isn’t right. Giving them the confidence to trust their instincts and escalate concerns can genuinely save lives.”
Find out more about our Sepsis Training for Care Staff and how it can support your organisation.
Red flag symptoms to look out for
The UK Sepsis Trust lists six red flag symptoms in adults. Treat any of these as urgent:
Slurred speech or new confusion
Extreme shivering or muscle pain
Passing no urine in a day
Severe breathlessness
“I feel like I might die”
Skin that is mottled or discoloured
The NHS also warns to act immediately if someone has blue, pale or blotchy skin, is breathing very fast, or simply looks seriously unwell. Trusting instinct is important: if something feels wrong, escalate.
(Sepsis Trust, n.d.)
What do you need to know in order to calculate a NEWS2 Score?
Respiration Rate (Per minute)
The number of breaths taken per minute is referred to as the respiration rate. When a person is at rest, the rate is normally measured by counting the number of breaths taken in one minute by noting how many times the chest rises. Fever, sickness, and other medical conditions can cause an increase in respiratory rate.
SpO2 % (Oxygen saturation in the blood)
Most first aid kits will not have a pulse oximeter. However, they are small, cheap and readily available from most pharmacies or online. They should come with instructions on how to use them. They normally measure both oxygen saturation in the blood and display this a percentage as well as displaying a pulse rate. It is worth noting that these devices are not always accurate and should be used as a guide. If a patient has very cold fingers, is wearing nail varnish or is moving around a lot the reading may be false. It is also important to note that patients with chronic (long term) lung problems may have a lower oxygen saturation level and that may be normal for them. This why there are two SpO2 scales on the NEWS 2 chart.
Blood pressure (Systolic mmHg)
Not everyone has access to a blood pressure machine. However, they are becoming ever more commonplace in homes. Blood pressure machines measure the pressure of the blood moving away from the heart (Systolic) and also the pressure of the blood returning to the heart (Diastolic). For the purpose of the NEWS 2 tool you’ll need to examine the systolic reading. This is normally displayed as the top number on a blood pressure machine.
Pulse (per minute)
To gain a pulse rate you may be able to use a pulse oximeter as shown above. However you can also get a more accurate reading by feeling for a pulse. The video below explains how to count a pulse by feeling a patients wrist.
Consciousness
First aiders are routinely taught to assess a patients level of response using the AVPU (Alert/Responds only to verbal stimuli/Responds only to pain stimuli/Unresponsive) scale. You’ll notice that there is an extra letter on the NEWS 2 chart. “C” means acute (new) confusion or disorientation.
Temperature (°C)
Many households now sport a temperature monitoring device especially since the onset of Covid 19. One important note is that there are many factors that can affect body temperature. If someone has had Paracetamol or Ibuprofen, these medications can lower core body temperature therefore if a patient has had these medicines recently then the temperature you record may not necessarily be accurate.
The bottom line
Sepsis is a silent emergency. It often begins with vague symptoms, but within hours it can become fatal. International research and UK guidelines agree: early recognition and escalation save lives.
By investing in dedicated sepsis training for care staff, organisations can close the training gap, support compliance with CQC requirements, and most importantly, protect the people they care for.
Equip your team with practical skills: Sepsis Training for Care Staff.
Frequently asked questions
Is sepsis included in first aid training?
Not usually. Most first aid syllabi focus on cardiac arrest, choking or bleeding. NICE explicitly recommends sepsis training for health and social care staff.
What should carers do if they suspect sepsis?
Escalate immediately according to local policy. This may mean alerting a senior colleague, GP, NHS 111, or calling 999. NICE guidance stresses early assessment and rapid transfer to hospital if sepsis is suspected.
Will carers learn to use NEWS2 in training?
Yes. Our face-to-face, clinician-led sepsis training gives carers the confidence to take a full set of vital signs and calculate a NEWS2 score. This means they can recognise deterioration earlier, speak the same language as NHS clinicians, and escalate concerns with clarity and confidence.
Are there any limits to using NEWS2?
Yes. NEWS2 is validated for use in adults aged 16 and over, and is not designed for pregnant women. Different tools are used for maternity and paediatric patients.
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NHS England (2021). National Early Warning Score (NEWS). [online] England.nhs.uk. Available at: https://www.england.nhs.uk/ourwork/clinical-policy/sepsis/nationalearlywarningscore.
Royal College of Physicians (2017). National early warning score (NEWS) 2. [online] Royal College of Physicians London. Available at: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2.
Royal College of Nursing (2021). Sepsis | Infection prevention and control | Royal College of Nursing. [online] The Royal College of Nursing. Available at: https://www.rcn.org.uk/clinical-topics/infection-prevention-and-control/sepsis.
Sepsis Trust. (n.d.). Home. [online] Available at: https://sepsistrust.org.
Sepsis Trust. (n.d.). Spot the signs. [online] Available at: https://sepsistrust.org/download/spot-the-signs/ [Accessed 15 Jun. 2022].
National Institute for Health and Care Excellence (NICE) (2016, updated 2024). Sepsis: recognition, diagnosis and early management (NG51). London: NICE. Available at: <a href="https://www.nice.org.uk/guidance/ng51" target="_blank">https://www.nice.org.uk/guidance/ng51</a> (Accessed: 23 August 2025).
UK Sepsis Trust (n.d.). Get Sepsis Aware: Red Flag Symptoms. Available at: <a href="https://sepsistrust.org/get-support/get-sepsis-aware/" target="_blank">https://sepsistrust.org/get-support/get-sepsis-aware/</a> (Accessed: 23 August 2025).
NHS (2024). Sepsis. Available at: <a href="https://www.nhs.uk/conditions/sepsis/" target="_blank">https://www.nhs.uk/conditions/sepsis/</a> (Accessed: 23 August 2025).
Office for National Statistics (ONS) (2024). Deaths involving sepsis, England and Wales: 2023. Available at: <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsinvolvingsepsisenglandandwales/2023" target="_blank">ONS 2023 report</a> (Accessed: 23 August 2025).
Royal College of Physicians (2019). National Early Warning Score (NEWS2). London: RCP. Available at: <a href="https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2" target="_blank">https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2</a> (Accessed: 23 August 2025).
PubMed Central (2024). Systematic review on early sepsis recognition and outcomes (PMC11221400). U.S. National Library of Medicine. Available at: <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11221400/" target="_blank">https://pmc.ncbi.nlm.nih.gov/articles/PMC11221400/</a> (Accessed: 23 August 2025).
