The US Centres for Disease Control & Prevention has released new guidelines for hospitals to detect and treat sepsis, a factor in 1.7m admissions in America each year, with about 350 000 of these patients dying or being moved to a hospice.
The road map, a 35-page document outlining the “core elements” of the sepsis programme, is meant to help administrators bring together experts from various medical disciplines to detect and treat sepsis faster, reports The New York Times.
Sepsis is an extreme immune response to an infection that sends a chain reaction through the body, which can result in tissue damage, organ failure and death. About one in three people who die in a hospital had sepsis during their time there, according to the CDC.
Despite its prevalence, hospitals often misdiagnose the illness because it is masked by common symptoms, like fevers and shivering, clamminess and shortness of breath, said Dr Hallie Prescott, a sepsis expert at the University of Michigan who helped develop the guidelines.
Sepsis detection and care also require co-ordination across departments and disciplines, a weak point in many healthcare settings.
A survey of more than 5 000 hospitals found that about 73% had sepsis teams, but only 55% had a leader with time allocated to manage the programme. Only about half of all hospitals integrate their sepsis programmes with antibiotic stewardship initiatives, despite the fact that these drugs are the key to recovery.
The CDC’s guidance explores the best practices for sepsis programmes in both large hospital systems and small rural facilities, including how to allocate personnel and financial resources, institute processes to improve case identification, and train staff to look for symptoms.
The agency said programmes should include experts from the hospital’s antimicrobial stewardship, the emergency room, infectious disease department and even the pharmacy – and should be led by both a doctor and a nurse.
Every hospital should have a well-rehearsed “code sepsis” protocol and a live dashboard for tracking various metrics in case management and outcomes.
The CDC also offered a detailed assessment tool to help apply the guidance to the local setting, as well as a list of first steps for the 1 400 hospitals in the US that, according to the survey, must begin from scratch.
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High rates of sepsis-associated acute kidney injury in SA ICU wards
WHO report on global epidemiology and the burden of sepsis — 1 in 5 deaths
Sepsis associated with 1 in 5 deaths globally, double previous estimate
10-minute blood test claimed to revolutionise sepsis diagnosis