Sepsis 2016 Paris
نویسندگان
چکیده
Background Sepsis affects over 26 million people worldwide each year resulting in a death every 3 to 4 seconds [1]. For every hour that antibiotics are delayed after the first episode of hypotension, there is a 7.6 % increase in the risk of mortality [2]. Thus, international sepsis guidelines recommend the administration of broad spectrum antimicrobial therapy within 1 hour of recognition [3]. In 2011, the New South Wales Clinical Excellence Commission (CEC) developed the Sepsis Kills program including the Adult Emergency Sepsis Pathway [4]. This pathway was introduced to Emergency Departments (ED) and auditing of time to first antibiotics commenced. Belmont Hospital Emergency Department has approximately 25000 presentations per year. In 2012, 163 patients were diagnosed with sepsis. Time to first antibiotics for sepsis patients peaked at 254 minutes (Fig. 1). Discussion of these results highlighted the need to develop education strategies in order to reduce time to first administration of antibiotics. Materials and methods Audits of the CEC Sepsis database [5] over 4 years included a total of 769 patients. Collected data entered included: age, triage time and category, clinical observations, time and amount of intravenous fluid, time to first antibiotics, and diagnosis. The tables provided reflect median time to antibiotics. In 2012 a Clinical Nurse Specialist from the ED was designated Sepsis Lead. Over 4 years, the Sepsis Lead worked collaboratively with clinical staff to develop and implement several strategies to decrease time to first antibiotics Results A multimodal approach strategy was adopted, which included: regular audits; targeted education programs for triage nurses and nursing team leaders; the introduction of Sepsis September a month dedicated to sepsis awareness and education; and the Sepsis Road show. These interventions were well received by Emergency staff. As a direct result time to first antibiotics was reduced to a median of 41 minutes (Fig. 2). Conclusions The collaborative effort between the Sepsis Lead and clinical staff has produced a significant reduction in time to first antibiotics from 254 minutes to 41 minutes at last audit. The success achieved at Belmont Hospital due to this multimodal approach strategy has the potential to be translated globally. It also serves to highlight the importance of the Emergency Nurse in early recognition and initiation of treatment for sepsis.
منابع مشابه
The Prevention of Sepsis in War Wounds, with Special Reference to the Carrel-Dakin Method
During my visits to France I have seen many hospitals in the English and French lines and in Paris where the scientific methods with which war wounds are now treated, even within a few miles of the firing-line, are in noticeable contrast with the unsatisfactory procedures adopted at the beginning of the war.
متن کاملHaemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France
We present a consensus report from the SFAR/SLRF (Société Française d'Anesthésie et de Réanimation/Société de Réanimation de Langue Française) Consensus Conference, held on 13 October 2005 in Paris, France. The consensus report made recommendations on five topics relevant to the treatment of circulatory failure in sepsis and its underlying rationale. These topics are as follows: therapeutic goa...
متن کاملIs exhaled nitric oxide a marker of air pollution effect?
Affiliations: Epidemiology of Allergic and Respiratory Diseases Dept (EPAR), Sorbonne Universités, UPMC Univ Paris 06, INSERM, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Saint-Antoine Medical School, Paris, France. Université Paris Descartes, Hôpital Cochin – Paris Centre, Assistance Publique Hôpitaux de Paris, Laboratoire de Physiologie Respiratoire, UPRES-EA ...
متن کاملArterial hypertension as an uninvited player in hepatic stiffness?
Vlad Ratziu, Dominique Valla, and Pierre-Emmanuel Rautou Service d’hépatogastroentérologie, Institute for Cardiometabolism and Nutrition, Hospital Pitié Salpêtrière, INSERM UMR S_938, Université Pierre et Marie Curie, Paris, France; INSERM, UMR-970, Paris Cardiovascular Research CenterPARCC, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; and Service d’hépatologie, DHU Unity Hôp...
متن کاملVisible light amination/Smiles cascade: access to phthalazine derivatives
Université Sorbonne Paris Cité (USPC), Pharmacie de Paris, UMR CNRS 8638 (COM Paris, France. E-mail: etienne.brachet parisdescartes.fr University of Regensburg Faculty of Chem Chemistry, Universitätsstraße 31, 93053 Re Université Sorbonne Paris Cité (USPC), Pharmacie de Paris, UMR CNRS 8015 (LC Paris, France † Electronic supplementary information ( and crystallographic data in CIF or 10.1039/c6...
متن کاملExact Algorithms for the Knapsack Problem with Setup
Fabio Furini PSL, Université Paris Dauphine, CNRS, LAMSADE UMR 7243 75775 Paris Cedex 16, France, [email protected] Michele Monaci DEI, University of Bologna, Viale Risorgimento 2, I-40136 Bologna, Italy, [email protected] Emiliano Traversi Laboratoire d’Informatique de Paris Nord, Université de Paris 13, Sorbonne Paris Cité, 99, Avenue J.-B. Clement 93430 Villetaneuse, France, emi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 20 شماره
صفحات -
تاریخ انتشار 2016