Answer To: (Frenchgirl) HCR4001 Social, Political & Environmental Issues in International Healthcare Essay Date...
Rimsha answered on Apr 30 2021
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Module Name: HCR4001— SOCIAL, POLITICAL & ENVIRONMENTAL ISSUES IN INTERNATIONAL HEALTHCARE
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Word Count: 3160
Table of Contents
Task A 3
Issues and Debates Related to Definition of Health within Dimensions of Sepsis 3
Task B 5
i. Impact of Economic, Political, Environmental and International Issues on Management and Prevalence of Sepsis 5
ii. Prevalence of Sepsis in India Compared to that in UK 6
Sepsis in India 6
Sepsis in UK 7
iii. Strengths and Limitations of Universal Prevention, Diagnosis and Management of Sepsis linking it with Sustainable Development Goals 7
Reflection 9
Description 9
Feelings 9
Evaluation 9
Analysis 10
Conclusion 10
Action Plan 10
References 11
Task A
Issues and Debates Related to Definition of Health within Dimensions of Sepsis
Sepsis can be defined as the life-threatening disease, which caused by the response of the body towards infection. It has been seen that human immune system response towards the infection occurs in the body by releasing the chemical, which fight against it. It has been seen that there is situation when immune system releases chemicals in the bloodstream to fight against the infection resulted into inflammation of the body. In severe cases, sepsis led to the septic shock. As mentioned by Gotts and Matthay (2016), every year around 30 million people suffered from the sepsis. The symptoms of sepsis include fever, heart rate above 90 beats per minute, high breathing rate.
In severe cases, symptoms of diseases include decreased urination, low platelet and breathing problem, patches of the discoloured skin, extreme weakness and unconsciousness. The impact of the sepsis can be moderate to severe and there are high chances of recovery. On the contrary, when sepsis enters the stage of septic shock, the chances of recovery reduce to 50% only. As suggested by van der Poll et al. (2017), it must be noted that sepsis can be triggered by pneumonia, abdominal infection, blood infection and kidney infection. Although, sepsis has same impact on everyone, however, some of the population are more vulnerable in comparison to others. The elderly population, young children and people with weak immune system are vulnerable in comparison to the other people.
As mentioned by Angus (2016), the definition of the sepsis has been revised three times since it was first defined in 1991. In 1991, first definition of the sepsis defines sepsis as systemic inflammatory response syndrome to the infection. It suggests that there are three levels of the illness, which include sepsis, severe sepsis and septic shock. This definition was developed with belief that sepsis shares the similar inflammatory pathway like trauma and pancreatitis. The definition remains the broad so that early detection of the disease can be taken place. The emphasis is made on understanding the process better that resulted into shock, organ dysfunction and death, so that interventions can be taken to control the disease.
On the contrary, as mentioned by Barbash et al. (2016), in 2001, other experts expanded the criteria for the systemic inflammatory response syndrome and increases the signs and symptoms that need to be considered in case of sepsis. In 1992, the symptoms for the sepsis include high fever, increase in heart rate, leucocytosis, increase in respiratory rate. On the contrary, the symptoms of the disease added hypothermia, tachypnoea, altered metal status, oedema, hyperglycaemia and increase in the leucocytes, arterial hypotension, acute oliguria, thrombocytopenia and decrease in the capillary refill. This resulted in change in the criteria for the identifying the patient with sepsis for research, quality improvement initiatives and clinical practice. In 2016, definition of the sepsis is revised further.
As noted by Cortes-Puch and Hartog (2016), the redefined definition of the sepsis states, “sepsis is a deregulated host response that causes life-threatening organ dysfunction, which is related to the acute change of at least 2 points in the sequential organ failure assessment (SOFA) score.” On the contrary, the severe sepsis term has been removed from the revised definition and organ failure is assessed using SOFA score. Apart from this, to conduct the SOFA, some of the early signs have been evaluated such as low blood pressure, high respiratory rate and altered mentation for the suspicion of infection. Apart from this, new definition has deleted the systemic inflammatory response syndrome (SIRS). It has been seen that SIRS criteria have been criticised for many years due to oversensitivity and non-specificity. On the contrary, the inflammatory pathway construct when treated with the therapies, it is designed to inhibit the host inflammatory response but there was no expected outcome by using the defined therapy.
As suggested by Calfee (2016), in some of the cases, pathogens contributed to worsen the scenario instead of the host body, these limitations resulted in the criticism of the SIRS criteria and otherwise it could be helpful in the quality improvement initiatives. There is no proper standard to identify the patients with sepsis. Over the period of past 25 years, the definition of sepsis is defined and redefined by various experts. It must be note that determining the diagnostic accuracy of defined and redefined definition is not done without a gold standard to identify the patient with the clinical syndrome.
It must be noted that changes in the definition occur with the breakthrough in the scientific knowledge or clinical evidence. In 2016, it has been suggested that the redefining of the definition occur due to recognition that sepsis resulted into activation of both pro and anti-inflammatory response, which result in reconsideration of the definition. It must be noted that switching from SIRS criteria to SOFA score was based on the ability to predict sepsis mortality (Calfee, 2016). On the contrary, the new definition, which required the presence of organ failure, may affect the general awareness of the importance of the recognition of the early signs and their treatment. It must be noted that patient with the sepsis must be identified before the organ dysfunction. The revised definition of the sepsis may identify the sick population and work in delaying of the treatment of the patients, which can be benefitted with early response. The new definition of sepsis raises many necessary questions and initiates the debate. According to new definition, a patient suffering from infection and have fluid-responsive hypotension must be categorised into uncomplicated infection (WHO, 2019). Generally, early recognition of the sepsis is considered as the best method to treat the patients especially living in the lower- and middle-income group. It must be noted that considering different kind of infection under one group and provide them therapy failed to give desired outcomes. It has been debated that new definition of the sepsis must be based on the scientific approach. Replacing of the widely accepted definition and...