Remember: Sepsis - the unrecognised killer
From the local audit undertaken given on the right:
What percentage of patients do you think received all appropriate sepsis six items?
What percentage of patients died?
Nottingham University NHS Trust – Local Audit (2009/10):
- 65 patients were audited who met the criteria of patients, with positive blood cultures, with severe sepsis within 24 hours admission to hospital
Commissioning for Quality and Innovation (CQUIN):
- £1 million for NUH if we meet target of > 50% of patients receiving antibiotics in < 1 hour
- Blood cultures, lactate and fluids in < 6 hours
- SEPSIS SIX: Concentrate on getting this right!
Recent changes from the 24 hour bundle:
- Blood sugar now has been discontinued by NICESUGAR trial so now is controlled to below < 10mmols
- Steroids now unproven but CORTICUS trial so now only used on AICU in patients who do not respond to noradrenaline
- Activated protein C has been withdrawn from the market as proven to be harmful
What can you do to help prevent a Sepsis related death?
Ensure the Sepsis Six is completed!
Reference:
- Simmonds, M; Hutchinson, A; Chikhani, M, Bewick, T; Meyer, J; Davies, S and Morris C (2008). Surviving sepsis beyond intensive care: a retrospective cohort study of compliance with the international guidelines. The Intensive Care Society Vol 9, Number 2, July 2008 124-127.
