Sepsis Rationale

By now you've heard that we're going to be initiating sepsis alerts to the hospitals. I previously did a video on sepsis and the pathophysiology behind sepsis, so I'm not going to get into that on this video. I'm simply going to talk about the rationale of why we're actually going to be alerting the hospitals about a incoming sepsis alert. The reason is this, and this is a new topic, so not everybody's familiar with the rationale for why we're doing this. And I'll just use stroke as an example. Years ago, before tpa, there was really nothing we could offer for stroke, even though it's one of the top killers in the United States. A patient would come in by fire rescue with a stroke, and we'd say, well, that's terrible for the patient. We'd stick the patient off to the corner because there was nothing to be done about it. And then TPA came about and we found, you know what, we can start fixing these people. We can make them better with certain treatments. And that's where the stroke alerts came into the hospital, so we could rapidly get them the treatment that they need. Well, with sepsis, we're dealing with a similar situation. Sepsis is actually the number three cause of death in the United States for hospitalized patients. It's actually if you die in the hospital, it's the number one cause of death of hospitalized patients. So whether you go to the hospital because you have a heart attack or a broken bone or need surgery or whatever, and you end up dying in the hospital, and it's usually because you've got an infection as a complication of one of those things, and you end up with septic shock and died. So we do know that sepsis is the number three killer in the United States. But in the past, there really wasn't a whole lot of therapy that we could offer those folks similar to where we used to be with stroke. But now we found that we've got scientific proof that timely treatment in sepsis care can improve the mortality rate. And the treatment is definitely time dependent, just like with stroke. Whereas in stroke we have to give the treatment within a certain time frame, with sepsis, we find that the mortality rate increases with each hour that you delay care. And the treatment is very simple. Two liters of fluid and early antibiotics, plus a few other interventions at the hospital have been shown to significantly decrease the mortality rate in sepsis. The sooner we give the antibiotics, the sooner we give the fluids, the lower the mortality rate. In fact, if we have a patient with sepsis who becomes hypotensive, they immediately jump into a mortality rate of 50%. We can prevent that by giving them 2 liters of fluid in the pre hospital phase. And then the timing of the antibiotics is critical because there's a linear mortality change with the delay of giving antibiotics. The sooner those antibiotics are given the just like TPA for a stroke, the better the outcome will be for the patient. So we do want to alert the hospitals that we're coming in with a sepsis patient. So just like for stroke, they're standing there waiting with tpa. They'll be standing there waiting with antibiotics. We've already discussed this with most of the hospitals. There's still a few that we need to work with, but they will be expecting these sepsis alert cases. They are using sepsis alerts within their emergency departments in the majority of the hospitals. So this is actually a new therapy that is, that is being rolled out across the nation because now we know that early intervention for septic shock does decrease the mortality rate and it is time dependent, just like STEMI and just like stroke alerts. So that's the rationale behind why we're actually going to be alerting our hospital colleagues for why we're bringing in a sepsis alert.