This month’s issue of the British Columbia Medical Journal (BCMJ) includes a publication by a group of BC physicians and researchers including our director, Kendall Ho, on the topic of improving management of sepsis in emergency departments in BC. The article contains a literature review and an examination of two provincial initiatives targeting the incorporation of best evidence into BC emergency department workflows.
From the abstract:
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments… Two BC-based initiatives, the Evidence to Excellence Sepsis Collaborative and Clinical Care Management, support improvements in management of sepsis in BC emergency departments, which should include early identification of septic patients, rapid and appropriate fluid resuscitation, lab tests (serum lactate and blood cultures), antibiotic administration, and source control of infection. Close clinical monitoring and biomarker (lactate) monitoring are also necessary during resuscitation to optimize safety and efficacy.
The article is well-timed as tomorrow in downtown Vancouver, UBC Continuing Professional Development is hosting the Western ED Operations Conference (WEDOC) conference, which “brings together physicians, nurses, administrators and decision-makers from British Columbia and Alberta to discuss and address issues that compromise patient flow and access to care in emergency departments (EDs). As the ED does not exist in isolation, a better understanding of the wider system issues affecting ED patient flow and overcrowding is crucial.”
Citation: Sweet D, Marsden J, Ho K, Krause C, Russell JA. Emergency management of sepsis: The simple stuff saves lives. BCMJ. 2012 May;54(4):176-182. [full text]