Early identification of sepsis cases in the emergency department using a symptoms-based screening tool significantly decreased the time interval for administering life-saving antibiotic treatment, according to research reported in the Journal for Healthcare Quality, the peer reviewed publication of the National Association for Healthcare Quality.
Early recognition and treatment of sepsis has proven to reduce mortality, and there is a need to more rapidly identify sepsis and septic shock patients in the emergency department. Elapsed time from triage to administration of antimicrobials is a major cause of mortality for patients with severe sepsis or septic shock.
At the Jewish General Hospital in Montreal, emergency department clinicians piloted a triage tool to identify patients presenting with common sepsis symptoms, such high fever, elevated heart and respiration rates and impaired mental function. Their study was designed to evaluate the benefit of the triage tool for identifying patients presenting in the ED with suspected severe sepsis or septic shock. One cohort was based on a retrospective chart review of ED patients with severe sepsis or septic shock, and a second cohort consisted of patients identified with the new triage tool and from a review of diagnoses from ED admission and discharge charts and death certificates.
Results showed that use of the triage tool significantly decreased the time from ED presentation to antibiotic treatment. The gains in time were most evident between one and four hours after arrival. "The data suggests that very sick patients were identified regardless of the triage method, whereas those with more occult sepsis might preferentially benefit from this tool," said lead author Catherine Patocka, senior resident, McGill University Hospital Emergency Residency Program.
- Catherine Patocka, Joel Turner, Xiaoqing Xue, Eli Segal. Evaluation of an Emergency Department Triage Screening Tool for Suspected Severe Sepsis and Septic Shock. Journal for Healthcare Quality, 2014; 36 (1): 52 DOI: 10.1111/jhq.12055
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