Severe Sepsis and Septic Shock: Clinical Audit 2016/2017 – National Report

Royal College of Emergency Medicine May 2017

This audit report  has shown the quality of care given to patients with severe sepsis and septic shock in emergency departments (EDs) has shown great improvement. Most EDs now have a sepsis lead (96%), a sepsis protocol (95%) and provide sepsis education (96%).

To read the full report, please follow this link.

Quality Improvement Initiative for Severe Sepsis and Septic Shock Reduces 90-Day Mortality: A 7.5-Year Observational Study*

Critical Care Medicine 45(2), February 2017, p 241–252

This study investigates the impact of a quality improvement initiative for severe sepsis and septic shock focused on the resuscitation bundle on 90-day mortality. Furthermore, effects on compliance rates for antiinfective therapy within the recommended 1-hour interval are evaluated. The article concludes, that the continuous quality improvement initiative focused on the resuscitation bundle was associated with increased compliance and a persistent reduction in 90-day mortality over a 7.5-year period. Based on the observational study design, a causal relationship cannot be proven, and respective limitations need to be considered.

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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Critical Care Medicine Volume 45(3), March 2017, p 486–552

A consensus committee of 55 international experts representing 25 international organisations was convened to provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.”

The panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. In conclusion, substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.

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Time to Treatment and Mortality during Mandated Emergency Care for Sepsis

New England Journal of Medicine May 21 2017

In 2013, New York began requiring hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. The article concludes that a more rapid completion of a 3-hour bundle of sepsis care and rapid administration of antibiotics, but not rapid completion of an initial bolus of intravenous fluids, were associated with lower risk-adjusted in-hospital mortality

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Chasing the Golden Hour – Lessons learned from improving initial neutropenic sepsis management.

This article details a Belfast Trust’s multidisciplinary efforts to improve awareness and compliance with regional neutropenic sepsis guidance. The primary project objective was to ensure that a consistent number of patients (greater than 80%) were receiving first dose empirical antibiotics within 60 minutes of presention to secondary care with suspected neutropenic sepsis.

To read the full article, please follow this link.