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Q: I hear that sepsis is an ever-increasing problem in nursing homes. We have just recently put my mom into a care facility. Do we need to be concerned? -- Lois D., Lebanon, New Hampshire

A: Unfortunately, as antibiotic resistance increases, sepsis is a growing threat. A Centers for Disease Control and Prevention study looked at data from 409 hospitals, and found that sepsis was present in 6 percent of all adult hospitalizations from 2009 to 2014. But 80 percent of sepsis infections happen outside of hospitals. According to NBC News, a federal report found that care related to sepsis was the most common reason given for transfers of nursing home residents to hospitals. (Sepsis treatment costs Medicare more than $2 billion annually.)

• What is sepsis?

Sepsis is your body’s overactive and toxic response to an infection. Staph infections, as well as infections with E coli and some types of Streptococcus (often associated with pneumonia and urinary tract infections), are frequent triggers, but even the flu can be the precursor. The elderly, babies under age 1, and anyone with a chronic illness or a compromised immune system is at risk. In the CDC study, 15 percent of sepsis patients died, but other research shows that among those with severe sepsis, almost one-third of patients don’t survive.

• Signs of sepsis

The first signs usually are a high fever, extreme pain, clammy skin, shortness of breath, rapid heart rate and, particularly in the elderly, cognitive decline, such as confusion and sleepiness. These should send you to an emergency room PRONTO!

• Treatment

Broad-spectrum antibiotics are administered, usually immediately, even though sepsis can be caused by a bacterial, viral, fungal or even parasitic infection. IV fluids also are administered to help prevent organ failure. Once blood tests are back treatment progresses on a case-by-case basis.

• Preventing sepsis

The CDC stresses the importance of hand-washing, wound care and being up-to-date on all vaccinations. In your mom’s case, Lois, also make sure she does not develop bedsores and the staff practices impeccable hygiene.

Q: I was walking on the sidewalk by the Capital building in Washington, D.C., and I almost got killed by one of these new electric scooters that are popping up everywhere. They are a menace to the riders and those around them! This is a public health issue, is it not? -- Andy F., Bethesda, Maryland

A: You bet it is! From San Francisco to San Diego and from Cambridge, Massachusetts, to Miami (including D.C.), these electric scooters are popping up as part of ride-share initiatives. And every place they show up, there’s a notable spike in emergency department visits for treatment of injuries more commonly associated with automobile accidents: broken hands, collarbones and jaws, and concussions. The Washington Post recently interviewed emergency docs in seven major U.S. cities, from Austin, Texas, to Nashville, Tennessee, and all of them reported increased injury rates after these ride-share programs started.

No matter how dangerous they are, looks like they’re here to stay. According to scooter advocates, these new alternative modes of public transportation are meant to “encourage safer and more sustainable transportation patterns” and there’s a lot of big money behind them. One scooter start-up company out of Santa Monica, California, just picked up $100 million in funding with plans to expand into 50 new markets before 2019.

What can be done to protect the riders who seem not to have the brains to protect themselves? California and Oregon now require helmets for E-scooter riders, while municipalities such as Los Angeles, San Francisco, Nashville, Cleveland, Cambridge, and neighboring Somerville, Massachusetts, have ordered one company to get them off the streets, since they put electric ride-share scooters on the streets without obtaining the proper permits.

We suggest riders stay in bike lanes, out of the flow of traffic and off pedestrian walkways. Helmets and knee and elbow pads are good safety precautions, too. As for pedestrians? Lobby for enforcing existing rules with your city councils, and keep your eyes wide open.


(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign) Distributed by King Features Syndicate, Inc.)

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