Sepsis early intervention saves lives, NSW study finds
An emergency room program that helps speed up the time it takes for patients to be treated with sepsis has been found to be successful.
The ‘SEPSIS KILLS’ program aims to reduce sepsis deaths by recognising the condition early and managing it promptly.
The program was introduced in 2011 to 97 NSW emergency departments and data from 13 567 patients were collected for the period 2011–2013.
According to research published in today’s Medical Journal of Australia, the sepsis death rate decreased from 20% in 2009 – 2011 to 14.1% in 2013 thanks to the introduction of the program.
Sepsis was involved in 17.5% of in-hospital deaths in 2009 in NSW and is one of the most common causes of clinical deterioration, causing more deaths than prostate cancer, breast cancer and HIV/AIDS combined.
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Authors Mary Fullick, Sepsis Program Lead at the Clinical Excellence Commission (CEC) in Sydney, Professor Mary-Louise McLaws, at the University of New South Wales, and colleagues wrote in the paper: “The focus of the program is to recognise risk factors, signs and symptoms of sepsis; resuscitate with rapid intravenous fluids and antibiotics; and refer to senior clinicians and teams.”
Since 2011, the changes include:
- Proportion of patients receiving intravenous antibiotics within 60 minutes of triage increased from 29.3% in 2009–2011 to 52.2% in 2013
- The percentage for whom a second litre of fluid was started within 60 minutes rose from 10.6% to 27.5%.
- The number of sepsis patients being treated immediately had increased from 2.3% in 2009 to 4.2% in 2013.
- The number of patients treated within 10 minutes of arrival increased from 40.7% in 2009 to 60.7% in 2013.
- There were also significant declines in time in intensive care and total length of stay.
As a result, NSW public hospitals have begun extending the SEPSIS KILLS program to inpatient areas and have introduced a 48-hour management plan for ward patients.
The authors conclude: By focusing on the principles of “Recognise, Resuscitate, Refer” it is possible to reduce the time it takes to start antibiotics and fluid resuscitation. This program could be applied in other jurisdictions and its integration with antimicrobial stewardship requirements should be considered.”
Read the research in the Medical Journal of Australia.