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Sepsis: What role do you play in improving outcomes?

In recent times, we have seen an influx of training, discussions and awareness-raising on sepsis – and rightly so!

Sepsis is a leading cause of death and disability that necessitates enormous costs on health care systems the world over (Schlapbach, Thompson and Finfer, 2019).

With World Sepsis Day knocking on our doors on September 13th, it is as good a time as any to ensure that as healthcare professionals, we are well-aware of how and why early recognition is important.

On 26 May 2017, the World Health Organisation (WHO) adopted a resolution on sepsis that urges member states to take action towards reducing the burden of sepsis across all age groups. 

The 2012 sepsis guidelines defined sepsis as ‘the presence (probable or documented) of infection together with systemic manifestations of infection’ (Dellinger et al., 2013). In the 2016 guidelines, sepsis is redefined by the task-force as a life-threatening organ dysfunction caused by a dysregulated host response to infection’ (Singer et al., 2016).

With the recent update to the sepsis guidelines, we have seen a shift in the definition of sepsis from one that focuses on the body’s response to infection to one that focuses on three critical aspects of sepsis- the presence of infection, the abnormal regulation of the host response to infection and the resulting organ system dysfunction as a result of the host response (Plevin and Callcut, 2017).

There’s no denying that sepsis can be tricky to identify and manage however it has been proven time and time again that ‘early identification and appropriate management in the initial hours after sepsis develops improves outcomes’ (Coopersmith et al., 2018)

Unfortunately, Sepsis is often under-diagnosed at the early stages however this is the critical time to begin treatment and potentially reverse it. According to Plevin and Callcut (2017), the biggest improvements in mortality have been a result of with early identification of sepsis, initiation of a 3-hour care bundle and rapid administration of broad-spectrum antibiotics. 

What can you do to improve the recognition and early management of sepsis in your workplace?

I’ve put together five tips that you can begin putting into action today to start your fight against sepsis.

  1. Refresh your knowledge of the current recommendations around the Management of Sepsis and Septic Shock.
  2. Review your workplace Sepsis Guidelines – critique them against the current guidelines and ask yourself if they need an update
  3. Participate in Sepsis Training to update your clinical knowledge and skills – you can start with our webinar, Paediatric Sepsis.
  4. Educate and empower the community by talking about Sepsis with your patients and their families
  5. Advocate for your patients – if you have that gut feeling that something is wrong, speak up and ask your team members to review your patient

Bibliography

Coopersmith, C., De Backer, D., Deutschman, C., Ferrer, R., Lat, I., Machado, F., Martin, G., Martin-Loeches, I., Nunnally, M., Antonelli, M., Evans, L., Hellman, J., Jog, S., Kesecioglu, J., Levy, M. and Rhodes, A. (2018). Surviving Sepsis Campaign. Critical Care Medicine, 46(8), pp.1334-1356.

Dellinger, R., Levy, M., Rhodes, A., Annane, D., Gerlach, H., Opal, S., Sevransky, J., Sprung, C., Douglas, I., Jaeschke, R., Osborn, T., Nunnally, M., Townsend, S., Reinhart, K., Kleinpell, R., Angus, D., Deutschman, C., Machado, F., Rubenfeld, G., Webb, S., Beale, R., Vincent, J. and Moreno, R. (2013). Surviving Sepsis Campaign. Critical Care Medicine, 41(2), pp.580-637.

Howell, M. and Davis, A. (2017). Management of Sepsis and Septic Shock. JAMA, 317(8), p.847.

Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med2013;41:580–637.doi:10.1097/CCM.0b013e31827e83af 

Plevin, R. and Callcut, R. (2017). Update in sepsis guidelines: what is really new?. Trauma Surgery & Acute Care Open, 2(1), p.e000088.

Schlapbach, L., Thompson, K. and Finfer, S. (2019). The WHO resolution on sepsis: what action is needed in Australia?. Medical Journal of Australia.

Singer, M., Deutschman, C., Seymour, C., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G., Chiche, J., Coopersmith, C., Hotchkiss, R., Levy, M., Marshall, J., Martin, G., Opal, S., Rubenfeld, G., van der Poll, T., Vincent, J. and Angus, D. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), p.801.

World Health Organization. (2019). Sepsis. [online] Available at: https://www.who.int/sepsis/en/ [Accessed 28 Aug. 2019].

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