Effective Prehospital Sepsis Screening Tool in Orange County, Fla., Helps Identify Severe Sepsis

Severe sepsis caused by overwhelming infection is responsible for significant morbidity and mortality among hospitalized patients.1 Early identification and aggressive treatment, particularly in regard to fluid resuscitation and antibiotics, has been shown to improve survival.2 The Surviving Sepsis Campaign has created guidelines for best practices, and federal reimbursement for sepsis care has been tied to resuscitation “bundles” encouraging such guidelines are followed. Clinical identification of sepsis commonly includes two or more of the systemic inflammatory response syndrome (SIRS) criteria in the presence of a suspected infection.1 A hallmark of severe sepsis is hypoperfusion leading to end-organ damage and cardiovascular collapse (i.e., septic shock). Objective measures for hypoperfusion allow for risk stratification along the continuum of the disease process. Elevated serum lactate levels (> 4 mmol/L) have traditionally been used as a sign of tissue hypoperfusion and an outcome predictor for septic patients.1,2 This has led to the development of screening tools and alert systems that may improve adherence to treatment guidelines. An analysis of sepsis incidence and outcomes in prehospital emergency care demonstrated that septic patients are commonly transported by EMS and have a high mortality rate.3 Several studies have shown that a large percentage of septic patients arrive at the ED by ambulance, including those that require critical care.3,4...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Source Type: news