We've written before about the catastrophic consequences of missed and delayed diagnosis of sepsis, rightly known as the hidden killer, responsible for claiming 52,000 lives a year in the UK and leaving survivors with life-changing injuries.
Now, following a huge amount of work by the UK Sepsis Trust, in conjunction with the Royal College of Physicians and NHS England, new treatment protocols for suspected sepsis have been issued by NHS England, which include the requirement for staff to alert senior doctors if patients suspected of having sepsis do not respond to treatment within one hour.
The guidelines, which aim to cut the number of deaths, will be reinforced from April via contractual obligations from hospitals that may incur financial penalties if not fulfilled.
Early treatment of sepsis is vital to saving the lives of patients developing the condition which occurs when the body responds badly to a bacterial infection and attacks its own tissue and organs.
Rather than demanding a firm diagnosis of sepsis, which can be hard to spot, the guidelines state that if a clinical team suspect the condition, they must treat the patient as if they do have it and bring in a senior clinician for further assessment within the one-hour time frame.
This is a subject close to the hearts of many of the team since we regularly deal with the tragedy that follows the death of a patient suffering sepsis in missed diagnosis cases. We shared our expertise on emergency medicine claims at a conference here on behalf of AvMA, where the clinical advisor to the UK Sepsis Trust, Dr Tim Nutbeam, discussed the guidelines and the treatment of sepsis. I also spoke about some of our cases.
Dr Nutbeam also said in the Guardian that the Trust welcomes the new initiatives which, if delivered correctly, will ensure prompt and effective treatment for patients who need it most.
In addition to new protocols, the NHS is also rolling out new systems to help clinical and nursing staff recognise when adult patients are severely ill. This includes a national early warning score (NEWS2), a chart listing several measurements which viewed together could help identify developing sepsis. For example, nurses can chart blood pressure changes, temperature changes, pain levels, and so on. Medics must also pay attention to family concerns, particularly regarding any significant change in behaviour.
When such observations are viewed together, they can provide an instant snapshot of whether a patient is deteriorating. Rolling this out across all NHS trusts will create a consistency of approach to recognising developing sepsis and treating it early.
The good news is that earlier diagnosis and treatment will have a huge impact on preventing the devastating effects of sepsis.