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Views And Reviews Acute Perspective

David Oliver: Sepsis—what’s behind the “hype”?

BMJ 2019; 367 doi: (Published 07 November 2019) Cite this as: BMJ 2019;367:l6327

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Re: David Oliver: Sepsis—what’s behind the “hype”? And there are other hypes too. All bad.

There was a time when “sepsis” simply meant that a part of the body was infected, It could be a septic finger. It could be “ septic abortion”. It could be an incised wound gone septic.
Now emblazoned in big red letters on a hospital lift is SEPSIS” . Instead of reading further, my first impulse is to avoid that lift.
I ask the charities behind the campaign to curb their enthusiasm. I ask those who decide on ICD snd hospital codes to use some discrimination ,.
Then there is Acute Kidney Injury. A raised serum creatinine leads to the label IKI. Inevitably an intravenous hydration follows. But the patient? He shakes his head and wails, “ But I have had no injury anywhere”. The nurse says - “ but you have acute kidney injury”.
I ask the nephrologists and charities : pray why can you not use a less horrifying term? Acute renal dysfunction for example. Any objections to my suggestion?
Thirdly the new disease : Prediabetes. It is horrifying to be labelled “ suffering from Pre-diabetes. Then they intone, “ you have 5 % chance of developing diabetes in 5…years. I reply ,” I am 86. In 5…years I expect I will be dead,”
I ask the well meaning diabetes nurses snd the diabetes charities, “ Why don’t you simply tell us to eat moderately.?”
Better still, sit down with us and discuss our food with us.
Haven’t got time? Then stop talking.

Competing interests: No competing interests

08 November 2019
JK Anand
Retired doctor
Free spirit
Peterborough, England