Emergency sepsis care improving

AN audit of sepsis care has shown improvement in the proportion of patients receiving basic interventions within the first hour of arriving at emergency departments.

The report published by the Royal College of Emergency Medicine (RCEM) presents findings from an audit of 13,129 adults presenting to 196 emergency departments (EDs). It shows a steady improvement in the Sepsis Six, an initial resuscitation bundle designed to offer basic interventions within the first hour of arriving at an ED  - but it also found that RCEM standards are not yet being met by all EDs.

Emergency antibiotic treatment has shown a steady improvement over the years with 44 per cent of at-risk patients now receiving them within an hour of arrival. The audit also found a slight improvement in the giving of IV fluids from 40 to 43 per cent. The taking of blood cultures and the measurement of lactate in the first hour have both improved, up from 40 to 45 per cent and 49 to 60 per cent, respectively. Documentation of urine output measurement is still poor at only 18 per cent.

Documentation of a full set of observations, including capillary blood glucose on arrival, is currently at 69 per cent although this is achieved by the upper quartile in 91 per cent of patients. Senior review of patients with sepsis is at 65 per cent and this could be an important factor affecting care.

Dr Taj Hassan, President of the Royal College of Emergency Medicine said: "Sepsis continues to be a leading cause of death in patients admitted to hospital as an emergency. It is vital therefore that staff in the Emergency Department are able to rapidly assess, recognise, risk stratify and treat such patients with proven evidence based therapy.

"Studies have repeatedly shown the power of the Sepsis-Six resuscitation bundle in improving patient care if delivered in a timely fashion."

Dr Jeff Keep, Sepsis Lead at the Royal College of Emergency Medicine added: “Almost all EDs have a sepsis lead, a sepsis protocol and provide sepsis education. This is a great achievement and shows how responsive emergency medicine is as a specialty to the many recommendations for improved organisation that have come from national reports."