Suspecting Sepsis

By Matt Reeves, DO, MBA, chief medical officer, Atrium Medical Center


Lori Nichols, RN, MSN, CCRN, ACNS-BC, CTTS, clinical nurse specialist, program manager, Senior Emergency Center, Atrium Medical Center

What scares you?

Losing a loved one, or a child? Cancer? Debt? North Korea? An equal opportunity killer?

Sepsis is the No. 3 cause of death in the United States each year – 258,000 people will die; one every 2 minutes. Per Bloomberg.com, America has a $27 billion sepsis crisis, and the country has only recently begun to understand the scope of the problem.

A new government report, “Trends in Hospital Inpatient Stay,” published in June 2017, suggests that sepsis cases tripled between 2005 and 2014. Whether that’s an alarming or misleading statistic, experts who study sepsis say it is actually reflective of doctors getting better at identifying cases.

Is your practice current?

Time and speed matter. Mortality increases 8 percent every hour that treatment is delayed. Because 85 percent of cases enter through the emergency department, the mantra “Suspect Sepsis. Save Lives.” is alerting staff to the medical emergency that is sepsis. Initiate the sepsis protocol and initiate the sepsis order set at first suspicion. Every minute counts.

Sepsis Core Measures include a patient meeting SIRS criteria. This early identification tool improves patient outcomes when treatment is started quickly. Ignoring or canceling the BPA delays treatment. There are no exceptions to the 30ml/kg fluid bolus, not even CHF. Lactate acid measures x2, appropriate antibiotics, and ICU placement for careful monitoring – when quickly provided – save lives. The follow-up Focused Exam reveals if the patient is responding or if further interventions – vasopressors – are needed.

You, as the physician, drive the bus, and you are supported by an increasingly educated team that also understands the need for speed.

Sepsis affects more than 26 million people worldwide each year. It is the largest killer of children and newborn infants in the world. In the United States, sepsis contributes to one in every two to three hospital deaths, and most of those patients had sepsis at admission. In total, more than 1.6 million people are hospitalized nationwide each year – one every 20 seconds.

Stay current. Provide proven treatment. Suspect Sepsis. 

Back to the March 2018 issue of Premier Pulse