Sepsis, one of the leading causes of death in U.S. hospitals, is a blood infection and an equal-opportunity invader, having the greatest impact on seniors and children. UPMC in central Pa.'s sepsis mortality rate is significantly below the national average.
Sepsis is a condition that arises when the body's response to an infection injures its own tissues and organs, sometimes progressing to septic shock. It may occur in up to 2 million U.S. patients every year, and, despite best practice, more than 1 in 10 sepsis patients do not survive.
According to the Centers for Medicare & Medicaid Services (CMS), sepsis is diagnosed when at least two of four abnormal vital signs occur in the presence of an infection, that include: high fever, low temperature, elevated heart rate and/or elevated white blood cell count. Sepsis affects all walks of life regardless of age, sex or race. Typically the very old or very young, or those with weak immune systems are affected more often.
S - Shivering, fever or very cold
E - Extreme pain or general discomfort
P - Pale or discolored skin
S - Sleepy, difficult to wake up, confused
I - 'I feel like I might die.'
S - Short of Breath
Sepsis is often associated with infections of the lungs, urinary tract, skin, and gut. Visit the CDC website to learn more about the signs and symptoms.
At UPMC in central Pa., we pride ourselves in the outstanding treatment and prevention methods we have developed in order to fight against sepsis.
UPMC in central Pa. implemented standard sepsis care utilizing the 3 and 6 hour CMS bundles with attention focused on early antibiotic administration and appropriate resuscitation in severe sepsis and septic shock.
Most sepsis patients come through the ER at UPMC in central Pa., so the first step is for the care team to be aware and recognize signs and symptoms through front-line staff education and early treatment intervention including:
UPMC in central Pa.'s dedicated sepsis team, including ICU physicians, emergency physicians, nurses and hospitalists, developed specific sepsis treatment protocols coined CALF (cultures, antibiotics, lactic acid and fluids). Lactic acid lab test barometer helps indicate how sick the patient is. If the initial lactic acid level is elevated, testing needs to be repeated within 3 hours. Our laboratory implemented a new, automatic process for repeating the test to improve reliability.
Early goal-directed-therapy order sets serves as a guide to evidence-based care. A Sepsis Alert helps to ensure 3- and 6-hour severe sepsis and shock bundles were provided. This process helps reduce mortality, especially in younger patients. The results were published in the American Journal of Respiratory and Critical Care Medicine.
As a result of the activities at our system, sepsis outcomes continue to improve.
Sepsis is one of the top leading causes of death in our nation's hospitals and a silent killer. As members of the larger health care community, we can save lives by pledging to protect, educate, and advocate for early sepsis diagnosis and prevention through vaccination and by taking steps within our hospital systems to standardize sepsis diagnosis for early, effective treatment.
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