Rapid identification and treatment of sepsis in emergency department helps Mercy exceed Ohio’s goal to reduce sepsis mortality and save lives
With a sepsis mortality rate of nine percent, Mercy Medical Center has demonstrated leadership in rapidly identifying and treating sepsis, an extreme response to infection in which the body releases an excess of chemicals into the blood stream, initiating an inflammatory process that can quickly reduce blood flow to vital organs, including the brain, lungs, and kidneys.
Of the one million sepsis cases in the United States annually, about 250,000 of those affected—or 1 in 4—die, making it the third leading cause of death in the nation.
“I’m very proud of the Mercy employees and staff members who have worked so hard over the past several years to meet and sustain Ohio’s sepsis mortality reduction goal,” says Paul Hiltz, Mercy president and CEO. “It’s another tangible representation of our unwavering commitment to patient safety, which we’ve made our highest priority.”
In 2018 Mercy Medical Center was awarded an ‘A’ from The Leapfrog Group’s Fall 2018 Hospital Safety Grade. The designation recognizes Mercy Medical Center’s efforts in protecting patients from harm and meeting the highest safety standards in the US.
Early Detection of Sepsis Is Key
According to Frank Kaeberlein, M.D., Emergency Medicine physician and the medical director of the Mercy Emergency Department (ED), the key to fighting sepsis is awareness and early detection. One day, or even a few hours, can mean the difference between life and death.
Dr. Kaeberlein says, “About 80 percent of sepsis cases come through the ED. We’ve been successful in our efforts to reduce sepsis mortality for two main reasons: we educate our ED, hospitalist, and intensive care unit (ICU) doctors and nurses to aggressively and carefully look for sepsis, and we give them the resources they need to swiftly treat it. For the 20 percent of patients that develop sepsis during their hospital stay, we have trained our inpatient nurses and staff to also look for the signs of sepsis, and then activate a Rapid Response Team to initiate timely treatment.”
Sepsis has a spectrum of symptoms, as well as severity—from simple sepsis (patients appear healthy but show some symptoms) to the extreme of septic shock (blood pressure falls dangerously low because the body cannot provide blood to vital organs). ED staff members focus on fever, elevated heart rate, rapid breathing, and altered mental status to identify possible sepsis and implement a treatment “bundle.”
Treatment “Bundles” Speed Sepsis Care
According to Kaeberlein, the use of three-hour and six-hour bundles—to be completed within three hours and six hours, respectively, of a patient presenting with possible sepsis—is crucial in the fight against sepsis throughout the hospital.
A three-hour sepsis bundle includes lactate level testing, blood cultures, broad-spectrum antibiotics, and fluid resuscitation. The six-hour bundle consists of vasopressors for patients with continued low blood pressure, re-assessment of fluids and blood flow, and a repeat of the lactate level.
“The Society of Critical Care Medicine and the American College of Emergency Physicians are currently working on a one-hour bundle with the goal of making sepsis treatment even faster,” says Kaeberlein. “We are also striving to reduce sepsis mortality through education for emergency medical service (EMS) technicians, as well as the public. At Mercy, our EMS liaison is already working with local EMS providers on sepsis.”
“It’s About TIME”
The Sepsis Alliance, the leading sepsis education and advocacy organization in the US, is helping increase sepsis awareness in communities and among health care providers. They have developed the acronym TIME to help people identify possible sepsis in a friend or loved one. TIME stands for temperature, infection, mental status, and extreme illness. To learn more about the Sepsis Alliance and their It’s About TIME campaign, visit https://www.sepsis.org/itsabouttime/.here for media inquiries