Sepsis in the Emergency Department: Improvements in Rapid Assessment and Treatment
Abstract
Sepsis remains one of the most deadly diseases in the country. According to the literature, a majority of sepsis cases filter though the Emergency department. The diagnosis and treatment of sepsis are complex and the barriers to improving these things are even more intricate but the fact remains that improvement of sepsis care begins in the ED. Early recognition of sepsis using the SIRS criteria followed by multidisciplinary rapid response diagnostic testing and treatment are the keys to improvement of sepsis care in the ED.
Introduction
Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al., 2013). Severe sepsis is defined by the SSC as “sepsis plus sepsis-induced organ dysfunction or tissue hypoperfusion” (Dellinger et al., 2013). Despite advances in treatment modalities, the current literature reports mortality for severe sepsis and septic shock ranges from 20% to 60% (Burney et al., 2012; Dickinson & Kellef, 2011; Turi & Von, 2011) making it the 10th leading cause of death in the United States. The prevalence of sepsis is markedly higher among the elderly population and rises exponentially after the age of 65 (Gaieski et al., 2010). With the baby boomer generation now approaching this age, systematic and effective treatment of sepsis has never been more important. Severe sepsis until the last decade was a grossly under recognized and undertreated illness. Although treatment protocols have improved impart due to the Surviving Sepsis Campaign, there exists an urgent need for improvement of prompt, methodical and aggressive care of severe sepsis and septic shock.
More than 500,000 cases of severe sepsis are initially managed in US emergency departments annually with an average ED length of stay for these patients of 5 hours (Wang et al., 2007). The SSC strongly recommends seven, time sensitive, initiatives. Within
Sepsis remains one of the most deadly diseases in the country. According to the literature, a majority of sepsis cases filter though the Emergency department. The diagnosis and treatment of sepsis are complex and the barriers to improving these things are even more intricate but the fact remains that improvement of sepsis care begins in the ED. Early recognition of sepsis using the SIRS criteria followed by multidisciplinary rapid response diagnostic testing and treatment are the keys to improvement of sepsis care in the ED.
Introduction
Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al., 2013). Severe sepsis is defined by the SSC as “sepsis plus sepsis-induced organ dysfunction or tissue hypoperfusion” (Dellinger et al., 2013). Despite advances in treatment modalities, the current literature reports mortality for severe sepsis and septic shock ranges from 20% to 60% (Burney et al., 2012; Dickinson & Kellef, 2011; Turi & Von, 2011) making it the 10th leading cause of death in the United States. The prevalence of sepsis is markedly higher among the elderly population and rises exponentially after the age of 65 (Gaieski et al., 2010). With the baby boomer generation now approaching this age, systematic and effective treatment of sepsis has never been more important. Severe sepsis until the last decade was a grossly under recognized and undertreated illness. Although treatment protocols have improved impart due to the Surviving Sepsis Campaign, there exists an urgent need for improvement of prompt, methodical and aggressive care of severe sepsis and septic shock.
More than 500,000 cases of severe sepsis are initially managed in US emergency departments annually with an average ED length of stay for these patients of 5 hours (Wang et al., 2007). The SSC strongly recommends seven, time sensitive, initiatives. Within
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