Emergencies | Prevent 10,000 sepsis deaths per year

80 percent of sepsis cases occur outside of hospitals and are time-critical emergencies. Photo: dpa/Julian Stratenschulte Every year, tens of thousands of sepsis die in Germany. This time-critical medical emergency (such as a heart attack or stroke) is still not familiar to all employees in emergency services or hospitals. Information and doubts from relatives are often responded to too late or not at all. This is also reflected in the fact that sepsis mortality in Germany increased by ten percent from 1990 to 2019. In Norway and Finland it fell by more than 20 percent each during this period.

Typical warning signs include confused thinking, shortness of breath, racing heart and low blood pressure as well as a strong feeling of illness, sometimes with pain or fear of death. High fever or sudden low temperature can be accompanying symptoms, as can complete exhaustion and clammy skin. The clinical picture often known as blood poisoning is more precisely an excessive reaction of the immune system, which always starts with an infection - this can "only" be a bladder infection, a wound or pneumonia. The released messenger substances flood the entire body and can quickly lead to organ failure and death.

»Security must be more important than hierarchy.«

With a view to World Sepsis Day on September 13th, the Sepsis Foundation provided information in Berlin last week about failures and also lighthouses in care. One of the problems is that a large proportion of German hospitals do not carry out systematic screening for signs of sepsis and no treatment regimens have been established, as Christian Scheer from the Greifswald University Hospital criticizes. For example, if infections occur on an implanted artificial joint, it must be surgically removed within six hours in the event of sepsis. Few hospitals are prepared for such cases. When it comes to antibiotic therapy, antibiotics with a broad spectrum of effectiveness should be used: “But even these may not be suitable for up to 50 percent of patients. A laboratory result takes three to five days. And in Germany only 15 percent of the laboratories are permanently operational.«

So far, only around five percent of German clinics have taken part in training on the topic. That should now change: Since January 2026, these training courses have been mandatory for at least 80 percent of medical and nursing staff as part of quality assurance. From 2027, fulfillment will be directly relevant to billing. The current inadequate situation is all the more annoying because the knowledge about sepsis is actually available.

Another major deficit is the lack of involvement of relatives and those affected. What is interesting in this context is that two deaths of children in both Great Britain and the USA led to new rules being established in a shorter period of time to speed up the detection of sepsis. In Great Britain these are summarized under the term Martja’s Rule. 13-year-old Martha had a bicycle accident and died in hospital in 2021 after suffering from sepsis, although her parents had repeatedly pointed out her poor condition. A campaign is leading to the new rule that patients, families and caregivers can request a dedicated emergency response team 24 hours a day. This was initially introduced for 140 hospitals in 2024, and then nationwide a year ago.

Kerstin Martensen from Jülich is now calling for a similar safety net for Germany. Her son Jann also died of undiagnosed sepsis. Martensen then initiated the Jülich sepsis pioneer region. Jann's rule is intended to strengthen early detection: any deterioration must be taken seriously and a medical re-evaluation must be achievable at a low threshold. Martensen explained that the rule is not intended to be a vote of no confidence against doctors and nurses, but: "Safety must be more important than hierarchy." This aspect could help ensure that the new goal of preventing at least 10,000 sepsis-related deaths annually in Germany is soon achieved.

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