Emergency guide

Sepsis kills 11 million people a year. Most deaths are preventable.

If you spot it in the first hours, you can survive it.

Sepsis is your body's emergency response to an infection going wrong. It can start from a cut, a chest infection, a urinary infection, or a recent surgery. Treated within hours, most people recover. Missed for a day, the chance of dying roughly doubles for every hour treatment is delayed.

This page is a plain-language guide to the warning signs, what they look like hour by hour, and exactly when to call emergency services. It does not replace medical advice — but it can help you decide whether to act now.

Run a 60-second self-check See the warning signs
11Mdeaths a year worldwide (WHO)
1 in 5of all deaths globally are sepsis-related
~7.6%increase in mortality for every hour treatment is delayed

What sepsis actually is

An infection — bacterial, viral, or fungal — gets into your bloodstream or triggers a system-wide reaction. Instead of fighting only the infection, your immune system starts damaging your own organs: your kidneys, lungs, heart, brain.

That collateral damage is sepsis. If it isn't stopped, organs fail and blood pressure crashes (this stage is called septic shock). The trigger is usually something ordinary:

  • A chest infection or pneumonia
  • A urinary tract infection (UTI), especially in older adults
  • A wound, cut, burn, or skin infection
  • Recent surgery — particularly abdominal or orthopaedic
  • Childbirth and miscarriage
  • An infected IV line, catheter, or implant
  • Severe COVID-19, flu, or other viral illness

The warning signs, in plain language

Doctors use criteria called SIRS and qSOFA. You don't need the jargon. Here is what those signs feel like in real life. If someone has an infection or has had recent surgery and shows any one of these — treat it as urgent.

Very high or very low temperature

Above 38.0 °C / 100.4 °F — or, more dangerously, below 36.0 °C / 96.8 °F. A surprisingly low temperature in someone who feels ill is a red flag, not a relief.

Racing heart at rest

Heart rate over 90 beats per minute while sitting still, with no obvious reason like exercise or anxiety.

Fast or laboured breathing

More than 20 breaths per minute at rest. Feeling unable to catch your breath. Talking in short sentences only.

Confusion, slurred speech, drowsiness

Not making sense. Not knowing where they are or what day it is. Hard to wake up. This is one of the most reliable warning signs and is often missed in elderly relatives.

Mottled, pale, or blue-tinged skin

Blotchy purple or grey patches, especially on knees, lips, fingertips. Skin that is cold and clammy. In darker skin tones, check the lips, tongue, palms, and soles for a grey or ashen tone.

No urine in 12+ hours

Not having peed all day, or passing very small amounts of dark urine, suggests the kidneys are shutting down.

"I feel like I might die"

An overwhelming sense of impending doom is a recognised symptom — listed by the UK Sepsis Trust and survivors. If a sick person says this, take it seriously.

Severe shivering or muscle pain

Rigors — uncontrollable shaking. Pain so bad it hurts to be touched. These often come before fever spikes.

Vomiting and not keeping fluids down

Especially in someone who already had an infection. Combined with low urine output, this can dehydrate dangerously fast.

For babies and small children — these are different

  • Mottled, bluish, or very pale skin
  • Extremely lethargic, hard to wake, or floppy
  • A weak, high-pitched cry, or no crying at all
  • A rash that does not fade when you press a glass against it
  • Fewer than half their normal wet nappies
  • Fast breathing, grunting, or pauses in breathing
  • Convulsions or fits

Any one of these in a child under 5 is a 999 / 911 emergency.

How sepsis unfolds, hour by hour

This is a typical pattern after an infection or surgery. It does not always go in order, and it can move much faster — sometimes hours, not days. The point is to recognise where on this curve someone is, and not to wait for the next stage.

  1. Hours 0–6

    Something is "off"

    You or someone you care for has had an infection, a surgery, a wound, childbirth, or a UTI in the last few days. Now they feel unusually unwell — tired, achy, mildly feverish. Easily confused with flu.

    Action: Note the time. Take a temperature, count the heart rate. Drink fluids. Don't dismiss it, especially if there's a recent infection or surgery in the picture.

  2. Hours 6–12

    The body's alarm fires

    Fever climbs, or temperature drops below 36 °C. Heart races. Breathing quickens. Strong shivers (rigors). Severe muscle aches. Maybe vomiting.

    Action: Contact a doctor or call a non-emergency medical line (NHS 111 in the UK, nurse line, urgent care). Say the word "sepsis": "I'm worried this could be sepsis." It changes how quickly you'll be seen.

  3. Hours 12–24

    The mind starts slipping

    Confusion. Slurred or rambling speech. Unusual drowsiness. Skin starts looking mottled, cold, or clammy. Urine output drops. The person says they feel "really wrong" or "like I might die."

    Action: This is the point at which delay starts costing lives. Go to an emergency department now, or call 999 / 911 / 112. Do not wait for a clinic appointment in the morning.

  4. Hours 24+

    Septic shock

    Blood pressure crashes. Skin is pale, blue-tinged, and cold. Barely conscious or unresponsive. Not passing urine. Breathing is rapid and shallow.

    Action: Call emergency services immediately. Do not drive — call an ambulance. While waiting, lay the person flat, raise the legs, keep them warm, stay with them. Tell the dispatcher: "I think this is sepsis."

Sepsis can skip stages. In babies, the immunocompromised, and after major surgery, it can collapse from "feels off" to septic shock in under six hours. Trust your instinct if something is badly wrong.

60-second self-check

For an adult or older child you're worried about. Tick anything that is true right now. This isn't a diagnosis — it's a structured nudge to help you decide what to do in the next few minutes.

Is there a recent infection or risk?
Red-flag symptoms (any one is serious)
Other warning signs

When and how to call for help

Call emergency services NOW

999 UK · 911 US/Canada · 112 EU/most of world

If any one of the red-flag symptoms is present:

  • Confusion, slurred speech, or hard to wake
  • Mottled, blue, or ashen skin
  • Severe shortness of breath
  • Not passed urine all day
  • A rash that doesn't fade under pressure
  • Very rapid deterioration

Say the word "sepsis" on the call. It triggers a faster pathway in most ambulance and hospital systems.

Call urgent / non-emergency care

NHS 111 UK · 811 Canada · GP / nurse line / urgent care elsewhere

If symptoms are amber and getting worse:

  • Fever or hypothermia with a recent infection
  • Heart racing, fast breathing, severe shivering
  • Vomiting and can't keep fluids down
  • You've had a recent surgery and feel unusually unwell

Tell them: "I'm worried this might be sepsis." If you can't get through quickly, treat it as an emergency.

What to tell them

  1. "I'm worried this could be sepsis."
  2. The recent infection, surgery, or trigger.
  3. The red-flag symptoms — confusion, mottled skin, breathing, urine output.
  4. Temperature, heart rate, breathing rate if you have them.
  5. Existing conditions and medications.
  6. Allergies — especially to antibiotics.

While you wait

  • Stay with the person. Don't leave them alone.
  • If they're conscious and not vomiting, sips of water are fine.
  • Keep them warm but not overheated.
  • If they collapse or stop breathing normally, start CPR if trained, and tell the dispatcher.
  • Write down when symptoms started — clinicians will ask.
  • Do not give paracetamol/ibuprofen just to mask a fever before assessment — the temperature itself is information doctors need.

If you've survived sepsis — what comes next

Roughly 1 in 2 sepsis survivors experience long-term effects: crushing fatigue, brain fog, anxiety, joint pain, weakened immunity for months. This is real and it has a name: post-sepsis syndrome.

It is not weakness or imagination. Recovery often takes 6–18 months. Going back to full life too quickly is one of the most common mistakes.

  • Tell your GP you had sepsis — ask for a follow-up plan.
  • Pace activity. Rest is treatment, not laziness.
  • Watch for any new infection — sepsis survivors are at higher risk of recurrence in the first year.
  • Get vaccinated against flu and pneumococcus if eligible.
  • Consider speaking to a survivor charity or peer-support group — see resources below.

Sources & where to learn more

World Health Organization Sepsis fact sheet — global burden, definitions, prevention. Surviving Sepsis Campaign The international clinical guidelines doctors use. The Hour-1 bundle is what hospitals are racing to deliver. UK Sepsis Trust Patient and family-facing resources, survivor support, and the symptom checklist that informed this page. Sepsis Alliance (US) US-focused education, survivor stories, post-sepsis support, and "It's About TIME" campaign. CDC — Sepsis US Centers for Disease Control: prevention, recognition, post-discharge guidance. NICE Guideline NG51 UK clinical guidance for recognising and managing sepsis. Useful if you want to know what a clinician should be doing.