COMMENTARY

Think Sepsis and Act Fast

Anthony Fiore, MD, MPH

Disclosures

September 26, 2016

Editorial Collaboration

Medscape &

This feature requires the newest version of Flash. You can download it here.

Hi. I'm Dr Anthony Fiore, chief of the Epidemiology Research and Innovations Branch within CDC's Division of Healthcare Quality Promotion. Today, as part of the CDC Expert Commentary series on Medscape, I would like to talk to you about protecting patients from sepsis.

CDC recently released a new Vital Signs report that focuses on the importance of sepsis prevention and early recognition. Sepsis is a clinical management challenge; it's difficult to identify and treat.

Time matters. When sepsis is quickly recognized and treated, more lives are saved. Healthcare providers are the critical link to preventing, recognizing, and treating sepsis.

To better describe the risk factors for sepsis, CDC and partners recently conducted a chart review of patients in four New York State hospitals.[1] This evaluation found that four types of infections most frequently led to sepsis: respiratory, urinary tract, skin, and abdominal. Other risk groups include people who are immunocompromised, people aged 65 years or older, and infants younger than 1 year.

The evaluation also found that sepsis begins outside of the hospital for nearly 80% of patients. Seven in 10 patients with sepsis had one or more chronic diseases, such as diabetes, that required frequent medical care, or the patient had recently used healthcare services for some other reason. As healthcare providers, we should view these regular medical visits as opportunities to prevent sepsis by educating patients and their families to prevent infections, properly manage chronic conditions, provide recommended vaccines, and recognize the early signs of severe infection and sepsis.

It's also critical that healthcare providers take action to improve early recognition and treatment of sepsis. Healthcare providers can:

  • Think sepsis. Know the signs and symptoms to identify and treat patients earlier.

  • Act fast. If sepsis is suspected, order tests to help determine whether an infection is present and identify its location and source. Start antibiotics and other recommended interventions immediately and document the dose and duration.

  • Reassess patient management. Check patient progress frequently. Reassess antibiotic therapy after 24-48 hours or sooner to change therapy as needed. Determine whether the type of antibiotics, dose, and duration are correct.

While certain people are at more risk than others, it's important to remember that even healthy people can develop sepsis from an infection, especially when not treated appropriately. Programs that reduce the risk for infections that can lead to sepsis present opportunities for sepsis prevention.

With these evaluation findings in mind, CDC, in partnership with organizations representing critical care specialists, hospitalists, nurses, emergency medicine clinicians, and patient advocates, is launching a comprehensive campaign targeting clinicians and the public. Our focus is to show that steps to prevent, urgently recognize, and properly treat sepsis are critical components of patient safety programs, and can be integrated into other patient safety initiatives, including antibiotic stewardship programs.

CDC partners are working to improve sepsis prevention and early recognition as well. Current efforts led by CDC and partners to improve sepsis surveillance will provide a more objective and consistent measure to track sepsis trends and evaluate interventions. These efforts will provide key information to improve overall prevention, recognition, and treatment efforts. Clinicians should also be aware of other recent developments in sepsis treatment. An international task force of critical care experts has recently published updated guidelines[2] on how to recognize patients with sepsis in the early stages and how to treat patients with suspected sepsis. Beginning in 2015, the Centers for Medicare & Medicaid Services required hospitals to track how quickly and completely they treated patients with suspected sepsis using a recommended set of treatments.[3]

Healthcare providers are the most critical link to preventing, recognizing, and treating sepsis. Talk to your patients and colleagues about sepsis and take action to prevent it. Be especially alert to infections among patients who are at higher risk; know the signs and symptoms; and act fast if sepsis is suspected. Your actions can have a substantial impact on reducing your patients' risk for sepsis and preventing more severe illness or death.

To learn more about sepsis and the CDC evaluation, please visit CDC's Vital Signs website.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....