Triage sepsis alert and sepsis protocol lower times to fluids and antibiotics in the ED

Hayden, Geoffrey E.; Tuuri, Rachel E.; Scott, R.; Losek, Joseph D.; Blackshaw, Aaron M.; Schoenling, Andrew; Nietert, Paul J.; Hall, Greg

doi:10.1016/j.ajem.2015.08.039

Cited by 93 publications

(89 citation statements)

References 30 publications

(25 reference statements)

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“…In this case, the patient was using the device, but other cases have been noted of spontaneous failure during storage and transport. Cases of documented blast injury have demonstrated directionality toward the upper and posterior oral cavity and palate causing fractures, burns, lacerations and dental injuries, including avulsion and fracturing of the teeth 3,4. These injuries have the potential to be permanently disfiguring and disabling with serious neurologic sequelae.…”

Section: Discussionmentioning

confidence: 99%

E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

Archambeau¹,

Lee²,

Pennington³

et al. 2016

WestJEM

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Electronic cigarettes (also known as e-cigarettes or e-cigs) are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device. Failures have occurred during both use and storage of the devices or their components. The subsequent injuries from several of these events, including full thickness burns requiring grafting and blast injuries, have been observed at Arrowhead Regional Medical Center, a regional trauma and burn center in southern California. One severe case resulted in several maxillofacial fractures, blurred vision, and pneumocephalus after a device failed catastrophically during use. The patient required close monitoring with serial imaging by neurosurgery in the intensive care unit and multiple procedures by oral maxillofacial surgery to reconstruct his facial bones and soft tissue. Ultimately, the patient recovered with minimal permanent damage, but the potential for further injury or even death was apparent. Cases such as this one are becoming more frequent. It is important to increase awareness of this growing problem for both medical professionals and the general public in order to curb this concerning new trend.

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Section: Discussionmentioning

confidence: 99%

E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

Archambeau¹,

Lee²,

Pennington³

et al. 2016

WestJEM

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“…Because lack of recognition prevents timely therapy, sepsis screening is associated with earlier treatment [43,44].…”

Section: We Recommend That Hospitals and Hospital Systems Have A Perfmentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

et al. 2017

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Objective: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". Design:A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. Methods:The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable.

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“…Less frequently, hospitals report surveillance of drug-induced physiologic events[17]. In general, we have created better CDS to identify patients undergoing clinical deterioration or at the first signs of sepsis by incorporating blood pressure, heart rate and respiratory rate into alerts[61,62]. Physiologic parameters such as blood pressure are drug induced and can be the next set of preventative ADE alerts we develop to improve patient care[3].…”

Section: Moving Towards Better Ade Preventionmentioning

confidence: 99%

Clinical decision support for drug related events: Moving towards better prevention

Kane‐Gill

Achanta

Kellum

et al. 2016

WJCCM

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Clinical decision support (CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors (ME) and adverse drug events (ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.

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Triage sepsis alert and sepsis protocol lower times to fluids and antibiotics in the ED

Cited by 93 publications

References 30 publications

E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Clinical decision support for drug related events: Moving towards better prevention

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