Management of severe sepsis and septic shock in the emergency department: a survey of current practice in emergency departments in England.
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.
Sivayoham
Narani
N
Emergency Department, St George's Hospital, Blackshaw Road, London SW17 0QT, UK. narani.sivayoham@stgeorges.nhs.uk
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
D000900:Anti-Bacterial Agents; D019344:Lactic Acid