Are adequate fluid challenges prescribed for severe sepsis?

Courtney, Michael J.; Gopinath, Bussa; Toward, Matthew; Jain, Rajesh; Rao, Milind

doi:10.1108/ijhcqa-01-2014-0013

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…It was uncommon, however, to take the patient’s body weight into account [ 37 , 45 ]. A questionnaire survey using case vignettes showed that, contrary to current guidance for IV fluid resuscitation in sepsis [ 46 ], junior doctors’ choices of IV fluid volumes were unrelated to body weight. In some instances, junior doctors were unaware of available guidance or struggled to reconcile differences between directives [ 2 , 29 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

Learning to prescribe intravenous fluids: A scoping review

McCrory¹,

Gormley²,

Maxwell³

et al. 2017

Perspect Med Educ

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IntroductionPrescribing intravenous (IV) fluid therapy is a core skill expected of qualified doctors at the point of graduation, but medical graduates often feel ill-equipped to perform this task. This lack of preparedness contributes to treatment-related patient harm. This scoping review maps the current state of published evidence about how junior doctors prescribe IV fluid therapy and learn how to do it.MethodsWe searched five electronic databases and grey literature from 1994 until June 2016 for articles describing any aspect of IV fluid prescribing practice or its education. A total of 63 articles were selected for analysis. Using the WHO Guide to Good Prescribing to categorize the extracted findings, our review focuses on prescribing IV fluids in adult generalist settings.ResultsMost articles studied IV fluid prescribing from the perspective of the doctor. Junior clinicians struggled to conceptualize IV fluid prescribing as a ‘whole task’ in authentic work settings and lacked support. Educational interventions to improve IV fluid prescribing often focused on enhancing prescriber knowledge about fluid and electrolyte balance rather than execution of the prescribing task.ConclusionsOur understanding of IV fluid prescribing as a holistic integrated skill is patchy, as is its performance. Current IV fluid prescribing education appears insufficient to foster safe and effective practice. For education to achieve the ultimate goal of safer prescribing in workplaces, we need a clearer understanding of how healthcare professionals prescribe IV fluids in real world practice.Electronic supplementary materialThe online version of this article (10.1007/s40037-017-0386-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Learning to prescribe intravenous fluids: A scoping review

McCrory¹,

Gormley²,

Maxwell³

et al. 2017

Perspect Med Educ

View full text Add to dashboard Cite

show abstract

“…Responses were compared with the Surviving Sepsis Campaign's recommended volume during the study (20 ml/kg). [9]. This similarity in poor management results only shows that its due to poor training and focus upon sepsis as a topic regarding its management.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…Matthew Toward, Rajesh Jain, Milind Rao done in in two UK hospitals, with 77 questionnaires were completed. In 2014 that showed there was no signi cant difference between doctor grades (FY1 and SHO) in any scenario[9]. This is most likely that Sepsis as topic overall is complicated when it comes to de nition and perception of its diagnostic criteria, and poor training might have a signi cant role in it as well.…”

mentioning

confidence: 97%

Knowledge assessment of Sepsis Diagnosis and Management during COVID-19 pandemic among House Officers & Medical Officers in Ibrahim Malik Teaching Hospital in Khartoum State, Sudan, 2021

Abdelrahman¹,

Ahmed²,

Mahgoub³

et al. 2021

Preprint

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Background: Sepsis is life-threatening and frequently a final common pathway to death for many infectious diseases worldwide and may lead to death if left untreated. The objective is to assess the scientific medical knowledge upon sepsis among House officers and Medical officers in terms of diagnosis and management.Method: An observational cross sectional Hospital-based study was conducted through self-administered retrospective questionnaires based on the objective of the study. We enrolled 155 participants through Convenience sampling. The questionnaire contains parts of validated Sepsis criteria in terms of diagnosis and management. Analysis was done by using SPSS version 20. Data are presenter as frequencies and percentages using figures and tables. P value less than 0.05 considered significant Mann Whitney U test use to compare level of knowledge adherence between trained participants and non-trained participants.Results: The mean knowledge score about sepsis diagnosis was 2.6 out of 10 (SD= 1.8), and about sepsis management was 2.8 out of 8 (SD=1.8) the mean overall score was 5.5 out of 18.No significant difference found between participants who were trained upon diagnosis and management of sepsis and those who were not.Conclusion: Study findings illustrated that the capacity to perceive and manage sepsis among House Officers and Medical Officers doctors is poor and there are dangerous gaps in their investigation and management of such septic patients.

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“…An optimization-driven tool could support junior doctors in determining optimal IV fluid treatments, who are usually among the first to treat patients. Courtney et al (2014) studied the infusion of intravenous fluids to patients by junior doctors. The study found that the majority of junior doctors do not prescribe the right amount of fluid and fail to adjust for volume by mass [6].…”

Section: Literature Reviewmentioning

confidence: 99%

“…SSC guidelines recommend varying the amount of fluid infusion at different disease severity levels. The study showed that 20% of all adults receiving fluid resuscitation experience complications owing to inadequate quantity of fluid resuscitation [6]. By the time senior doctors review the treatment, the early intervention window has passed, which is critical for sepsis treatment [7].…”

Section: Introductionmentioning

confidence: 99%

Optimal Sepsis Patient Treatment using Human-in-the-loop Artificial Intelligence

Gupta¹,

Lash²,

Nachimuthu³

2020

Preprint

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Sepsis is one of the leading causes of death in Intensive Care Units (ICU). The strategy for treating sepsis involves the infusion of intravenous (IV) fluids and administration of antibiotics. Determining the optimal quantity of IV fluids is a challenging problem due to the complexity of a patient's physiology.In this study, we develop a data-driven optimization solution that derives the optimal quantity of IV fluids for individual patients. The proposed method minimizes the probability of severe outcomes by controlling the prescribed quantity of IV fluids and utilizes human-in-the-loop artificial intelligence. We demonstrate the performance of our model on 1122 ICU patients with sepsis diagnosis extracted from the MIMIC-III dataset. The results show that, on average, our model can reduce mortality by 22%. This study has the potential to help physicians synthesize optimal, patient-specific treatment strategies.

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Are adequate fluid challenges prescribed for severe sepsis?

Abstract: This, the first case-based survey the authors could find, highlights an issue requiring significant improvement. The implications are likely to be relevant to clinicians in all UK hospitals.

Cited by 7 publications

References 18 publications

Learning to prescribe intravenous fluids: A scoping review

Learning to prescribe intravenous fluids: A scoping review

Knowledge assessment of Sepsis Diagnosis and Management during COVID-19 pandemic among House Officers & Medical Officers in Ibrahim Malik Teaching Hospital in Khartoum State, Sudan, 2021

Optimal Sepsis Patient Treatment using Human-in-the-loop Artificial Intelligence

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Are adequate fluid challenges prescribed for severe sepsis?

Abstract: This, the first case-based survey the authors could find, highlights an issue requiring significant improvement. The implications are likely to be relevant to clinicians in all UK hospitals.

Cited by 7 publications

References 18 publications

Learning to prescribe intravenous fluids: A&nbsp;scoping review

Learning to prescribe intravenous fluids: A&nbsp;scoping review

Knowledge assessment of Sepsis Diagnosis and Management during COVID-19 pandemic among House Officers &amp; Medical Officers in Ibrahim Malik Teaching Hospital in Khartoum State, Sudan, 2021

Optimal Sepsis Patient Treatment using Human-in-the-loop Artificial Intelligence

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Product

Resources

About

Learning to prescribe intravenous fluids: A scoping review

Learning to prescribe intravenous fluids: A scoping review

Knowledge assessment of Sepsis Diagnosis and Management during COVID-19 pandemic among House Officers & Medical Officers in Ibrahim Malik Teaching Hospital in Khartoum State, Sudan, 2021