title: Management of severe sepsis and septic shock in the emergency department: a survey of current practice in emergency departments in England.
abstract: OBJECTIVE
  To identify the extent to which emergency departments (EDs) in England are involved in the initiation of the pathway to early goal-directed therapy (EGDT) in patients with severe sepsis and septic shock.
  
  
  METHODS
  A survey of 173 EDs in England was carried out over a 2-month period starting in March 2006.
  
  
  RESULTS
  117 (67.6%) departments responded. 22 (18.8%) departments satisfied the following criteria: had a strategy to identify these patients, measured lactate, had a written protocol including EGDT and provided training for their staff. A further 10 (8.5%) EDs were working on initiating the pathway to EGDT.
  
  
  CONCLUSIONS
  18.8% of EDs in England are able to initiate the pathway to EGDT in patients with severe sepsis and septic shock.
authors.affiliation: Emergency Department, St George's Hospital, Blackshaw Road, London SW17 0QT, UK. narani.sivayoham@stgeorges.nhs.uk
authors.forename: Narani
authors.initials: N
authors.lastname: Sivayoham
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002985:Clinical Protocols; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England; D005440:Fluid Therapy / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D012772:Shock, Septic / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D019344:Lactic Acid