ManitobaA Winnipeg sepsis survivor says he wants to see Manitoba follow Nova Scotia’s lead and change how it treats the condition that almost killed him nine years ago. Unlike Manitoba, Nova Scotia now allows nurses, paramedics to order sepsis antibioticsAn infection on Mac Horsburgh’s finger turned into a septic shock that almost killed him nine years ago. The survivor wants to see Manitoba better identify and treat sepsis to prevent more cases like his. (Submitted by Mac Horsburgh)A Winnipeg sepsis survivor says he wants to see Manitoba follow Nova Scotia’s lead and change how it treats the condition that almost killed him nine years ago. “I came out of this in many ways a better person, but it was at a huge cost to me and my family for a period of time,” Mac Horsburgh told CBC News. Horsburgh collapsed after a cyst on his finger was misdiagnosed as an inflammation and left untreated for days. The infection got into his bloodstream, weakened a vessel and created an aneurysm that ruptured. At the time he was experiencing the most severe stage of sepsis — an extreme physical response to an infection that can cause organ failure, tissue damage and death.Horsburgh’s doctors told his family they were not optimistic he would live. But after surgery, 10 days in a coma, three weeks in an intensive care unit and more than a week in a recovery unit, Horsburgh was discharged.”I was ecstatic to be alive, but at the same time I was enraged that a simple infection in my finger could create this kind of trauma for me and my family,” he said. Horsburgh spent 10 days in a coma and three weeks in the intensive care unit after a cyst on his finger led to sepsis that almost killed him nine years ago. (Submitted by Mac Horsburgh)For years, Horsburgh didn’t know that sepsis was what almost killed him, and he’s since learned it could have been prevented if the infection had been treated earlier.”Medical care services saved my life, but medical care in the early stages created the problem for me too,” he said. “I’ve struggled with the idea that we’re not doing enough for sepsis patients.”But with a recent plan in Nova Scotia to speed up sepsis treatment, Horsburgh sees an opportunity for change in Manitoba too.Changes in Nova ScotiaNova Scotia’s health system is transitioning to allow nurses and paramedics in emergency rooms and urgent treatment centres to start antibiotic treatment — without a doctor’s order — for a patient believed to have sepsis.Nova Scotia ERs once had the capacity to medicate patients with sepsis soon after triage, but that’s no longer the case due to soaring wait times, said Dr. Vanessa Sweet, an anesthesiologist and co-lead of the province’s sepsis action improvement plan.Nova Scotia began testing its new sepsis response in July 2024 and rolled it out provincewide in September.The hope is to speed up response times to treat the disease, which Sweet said had become a key driver of hospital deaths in the province.Dr. Vanessa Sweet, the co-lead of Nova Scotia’s sepsis action team, says it’s critical to move quickly to treat sepsis in the emergency department. (Gareth Hampshire/CBC)”The earlier we can move that critical piece in a patient’s journey in the emergency department, the better,” she said. “You can get into a situation where your blood pressure drops dangerously low and various organs start to not function.”Nova Scotia has also outfitted health-care centres with sepsis treatment kits, as well as introducing a standardized protocol to detect the disease.The province also now provides information packages for sepsis patients during recovery — something Horsburgh said would have helped him when he was discharged, with little information.”My life had become a big puzzle, but I was missing a lot of pieces,” he said. ‘Actions speak louder than words’According to the Canadian Sepsis Foundation, as many as one in 18 deaths in Canada involve sepsis, making it the 12th-leading cause of death nationally. It’s one of the most common reasons for admissions at Winnipeg’s intensive care units, says an infectious diseases and critical care physician.While the sickest patients with sepsis are treated almost immediately, those with a mild degree of infection generally have to wait longer in the ER for a prescriber who can order antibiotics, said Dr. Sylvain Lother. But giving nurses and paramedics — who are generally the first to detect the disease — the power to start treatment early on could help prevent serious complications for patients with a moderate infection, he said.”Getting testing done more rapidly and getting the treatment started immediately could lead to symptoms improving a lot faster,” said Lother.A file photo shows a nurse in an intensive care unit. In Manitoba, only nurse practitioners, doctors and clinical assistants can prescribe sepsis medication, but a spokesperson says the province is looking at expanding that list. (Evan Mitsui/CBC)But any change has to come with staff training and protocols so the right medication is administered, he said.”If we prescribe an antibiotic that’s not … potent enough, it’s not killing the bacteria. We know that’s associated with a near doubling in the mortality risk,” Lother said. “On the flip side, overuse of antibiotics leads to organisms that are resistant, and then we have problems … where future infections may be more challenging to treat.”In Manitoba, nurses can initiate lab work to test for sepsis when it’s suspected in the emergency room, according to Shared Health. But antibiotics or IV treatment have to be ordered by a physician, physician assistant, nurse practitioner or clinical assistant before they can be administered.A spokesperson for the health minister said the province is focused on making sure all patients with sepsis get the same treatment across Manitoba.The province is looking at expanding who can prescribe sepsis medication in the future, the spokesperson said, but they didn’t give a timeline.The Manitoba Nurses Union is in favour of letting nurses order sepsis medication.”Very much like a stroke, time is very important,” said union president Darlene Jackson. “If you can get those procedures and those protocols started quickly, then your patient has a better chance of full recovery.”Horsburgh is encouraged that the province is exploring options to improve sepsis care, but his optimism is cautious.”Words are one thing,” he said. “Actions speak louder than words. So I’m still going to wait and see.”WATCH | Sepsis survivor pushes Manitoba for change in treatment:Sepsis survivor pushes Manitoba for change in disease’s treatmentMac Horsburgh, who nearly died from sepsis, wants Manitoba to improve treatment and detection. Nova Scotia recently began allowing nurses and paramedics to initiate antibiotics for the most severe infections in the emergency department without a prescriber’s order. ABOUT THE AUTHORSantiago Arias Orozco is a journalist with CBC Manitoba currently based in Winnipeg. He previously worked for CBC Toronto and the Toronto Star. You can reach him at santiago.arias.orozco@cbc.ca.
Change needed in how Manitoba treats sepsis, says man who nearly died from condition
