Surviving Sepsis Campaign in Cork University …

1 Surviving Sepsis Campaign in Cork University hospital A/CNM 2 For the acutely ill and deteriorating patient Claire Costigan Shocking Facts Sepsis is a medical emergency Predicted to grow Failure to see Sepsis , Severe Sepsis or Septic Shock is TIME CRITICAL! TRAUMA GOLDEN HOUR AMI TIME IS MUSCLE STROKE TIME IS BRAIN Sepsis TIME IS LIFE What is Sepsis ? Remember ! 3 T s Milk and Sugar Tachycardia Tachypnea Temperature White Cell Count Blood Sugar Level Look for Altered mental state and ask Sites of Infection SIRS Criteria +Suspected Infection Source= Sepsis Sepsis Management Surviving Sepsis Campaign Joint collaborative The Aim Evidence-based Guidelines (2004) Revised April 2015 The Bundle/Database National Clinical Guideline (HSE, 2014) Early recognition Appropriate treatment Maximise survival and minimise the burden of chronic sequelae. SCC and CUH My role Over a 6 month period there was 321 admissions to GICU.

2 94 ( ) of patients were admitted into GICU with a diagnosis of Sepsis . 77 patient charts reviewed 0 10 20 30 40 50 60 70 80 90 100 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Percent in Compliance Initial hour Bundle Serum lactate within 3 Hrs Blood Culture before Antibiotics Antibiotic Compliance Fluids for hypotension or elevated lactate The findings Survival rates have trended upwards. September was the best month for all elements being carried out on 1/3 of patients within the time frame. Higher adherence to the early antibiotic the higher the survival rate. Survival rates v Antibiotic compliance 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Antibiotic Compliance Survival Areas for improvement Compliancy with taking Lactates early and within the time frame is at 61% average. The administration of 30mls/kg in bolus format is currently at an 8% average Take away message