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Time to Act: Severe sepsis - rapid diagnosis and treatment saves lives

Analysis

Summary of shortcomings

In the ten case stories described in this report, the shortcomings, compared with the applicable standards, are:

Clinical Care

Standard

Number at variance

Timely history and examination on admission or referral. 6
Investigations to determine:
  • Indices of perfusion
  • Indices of infection
  • Source of infection
  • Cultures of blood and other sites.
7
5
4
6
5
Regular physiological monitoring using track and trigger systems. 3
Accurate recognition of severity of the illness.     7
Basic resuscitation with: 
  • Large-volume fluid therapy
  • Intravenous broad-spectrum antibiotics after taking cultures
  • Vasopressor therapy if required to maintain adequate haemodynamics and tissue perfusion.
8
7
7
5
 
All of these actions to commence immediately on recognition of severe sepsis and to be completed within six hours. 5
Source control to be performed as soon as possible after initial fluid resuscitation. 5

 

Organisation of care

Standard

Number at variance

Adequate education and training of staff. 2
Appropriate and timely senior medical input. 6
Timely referral to critical care. 5
Formation and documentation of a management plan. 1
Handover according to protocol.     1
Appropriate and timely referral for source control. 1