SIRS

Evolving sepsis definitions and their impact on Acute Medical Units

Background: There are currently several different definitions for sepsis. This study looked at what proportion of acute medical admissions were identified by the different definitions, what correlation they have, and how many patients would require a review with results in 1 hour.

Methods: Data on 212 admissions was collected, on time of admission and review, and number of patients with sepsis by each diagnostic criteria calculated.

Results: The NICE criteria identified 69% of admissions as requiring review within one hour, compared to 6% with qSOFA and 18% with previous sepsis definitions. The mean time to review was 1hr 18min, and only 50% of patients meeting the NICE criteria were reviewed within one hour.

Conclusions: The proposed NICE guidance will be challenging to implement with current resources.

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Emergency assessment and management of the septic patient

Abstract

Sepsis is a common problem in hospital practice. As well as being an important precipitant of hospital admission many patients develop the problem after arrival in hospital, including in excess of 500,000 patients in critical care units across each year. Over one-half of all infections in critical care units are associated with severe sepsis or septic shock.1 Despite major research effort in this area and the introduction of new therapeutic agents, mortality from septic shock remains high (50-70%). With the ageing population, emerging antibiotic resistance, and increasing use of immunosuppressive healthcare, sepsis is set to become an even greater drain on healthcare resources. The early recognition and appropriate management of sepsis is important. There is increasing evidence that an immediate, proactive approach has prognostic significance.

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