Improving Outcomes in Sepsis Patients in the Emergency Department

Improving Outcomes in Sepsis Patients in the Emergency Department

Sepsis is a left threatening illness that affects millions of people each year. The Center of Disease Control reports sepsis as the 10th leading cause of death in the United States. For adults age 65 and over hospital admission because of sepsis have increased 48%. The body’s immune system switches into “high gear” which overwhelms the body’s normal blood flow and oxygenation of tissues throughout the body. This process, if not treated in time, can quickly lead to organ failure and death. Approximately one third of people diagnosed with sepsis die from it. The role of emergency departments throughout the country has become vitally important to the early detection and treatment of sepsis. With the implementation of sepsis protocols in the emergency department the mortality of patients with sepsis admitted through the ED is significantly lower.

The word sepsis is commonly used to diagnose patients, but the debate continues as to the true definition. The word sepsis comes from the Greek meaning decay or to putrefy. Sepsis is a general term that is applied to patients that develop clinical signs of infection. Unlike other diseases sepsis is not diagnosed by the location or type of microbe involved in the infection. Some of the criteria used to diagnose sepsis are abnormalities of body temperature, pulse, respirations, and white blood cell counts. Some symptoms that are common in septic patients are fever, hypothermia, heart rate greater than 90 beats per minute, altered mental status, swelling of the extremities, and high blood glucose in diabetic patients. Sepsis is considered severe when there is organ dysfunction involved. Some examples of this kind of dysfunction are low oxygen level, low urine output; high levels of creatnine in the blood, absent bowel sounds, and low platelet count in the blood. The scary fact about sepsis is that it can occur in incidents as minor as a scrape from a minor fall. American hospitals spend approximately twenty billion dollars a year fighting sepsis. Sepsis must be considered a medical emergency. “A 2006 study showed that the risk of death from sepsis increase by 7.6% with every hour that passes before treatment begins.”.

Sepsis begins with the entry of an organism into the bloodstream through the skin, respiratory, genitourinary, or gastrointestinal tract. The organism can be bacteria, yeast, virus, or parasites. Sepsis is a complex syndrome characterized by the body’s activation of inflammation and coagulation in response to the introduction of the foreign organism into the bloodstream. The body also releases cytokines, which play an important role in the inflammatory and immune response. As the foreign organism circulates throughout the bloodstream, more phagocytes, leukocytes, and cytokines are activated. The cytokines and white blood cells increase capillary