Understanding of Severe Sepsis and Septic Shock Among Emergency Department and Intensive Care Unit Medical Officers in a Developing Country Nepal: A Survey Study

Abstract

KEY WORDS IntroductionSevere sepsis and septic shock is a major cause of morbidity and mortality. The burden is higher and the outcome is dismal in the low and middle income countries. ObjectiveThis study aims to evaluate the knowledge about severe sepsis and septic shock among the medical officers of emergency department and intensive care unit in Nepal. It is a cross-sectional survey study. MethodologyThe medical officers working in emergency department and intensive care unit were asked to fill up the survey questionnaire, which contained the questions related to the demographics of the participant, about the knowledge of sepsis and the hindrances behind the effective management of septic patients. The percentage of correct answers for each question and average correct response for all the questions were analyzed. ResultsSeventy medical officers from twenty-four hospitals across the country were enrolled in the study. Among them, 39 were working in the emergency department and 31 were working in the intensive care unit. For the individual questions, the percentage of correct answers varied from 8.57% to 82.86% (average 48.16%). As per the response of the participants, lack of knowledge about sepsis and management guidelines, lack of experience for management of sepsis and lack of investigation facilities were considered to be the major barriers for effective management of septic patients. ConclusionsKnowledge and understanding about severe sepsis and septic shock among the medical officers of emergency department and intensive care unit in Nepal is sub-optimal. To improve the outcome of septic patients, efforts should be made to increase the understanding among these first-line health care workers by implementing regular and mandatory training programs. Knowledge, medical officer, septic shock, severe sepsis Affiliation:1.

Management of sepsis in resource poor countries: cutting your coat according to your cloth

“…These findings may not be generalized to LMICs where the trained health care workers are limited and mortality of sepsis remains high. 2,15,17 In resource limited settings with scarcity of trained personnel, use of protocols and checklists would depend less on highly specialized knowledge and may improve outcome. [18][19][20] Recommendations for management of sepsis in resource poor setting should consider availability of resources, feasibility, affordability and safety; similar to the concept of cutting the coat according to the cloth.…”

“…12 Knowledge and understanding of sepsis if often sub-optimal in the first line health care workers from resource limited settings. 15 Training of medical practitioners about recognition of sepsis, resuscitation and monitoring can improve the care of these patients. 12 Introduction of early goal-directed therapy (EGDT) for treatment of sepsis and septic shock revolutionized the management of sepsis.…”