title: Towards 'sepsis with optimal treatment': evaluating the sepsis care pathway in acute medicine and identifying scope for systems improvement.
abstract: Sepsis commonly presents to the acute medicine unit (AMU). Timely recognition and treatment can reduce the significant associated mortality, but United Kingdom AMUs and emergency departments are often inadequately equipped to manage sepsis with early-goal directed therapy. We conducted an observational study of 50 consecutive patients admitted with severe sepsis. Demographic, physiological and microbiological data, and information about the provision and timing of care were collected in real time. Treatment fell below "surviving sepsis" targets with only 28% of patients receiving sufficient fluid, and 64% receiving antibiotics within 3 hours, associated with delays in seeing physicians; however despite this mortality was lower than the nationally quoted average (14% at 90 days).
authors.affiliation: Adult Intensive Care Unit, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU. joel.meyer@ndm.ox.ac.uk
authors.forename: Joel
authors.initials: J
authors.lastname: Meyer
authors.forename: Z
authors.initials: Z
authors.lastname: Fritz
authors.forename: H
authors.initials: H
authors.lastname: Burton
authors.forename: C
authors.initials: C
authors.lastname: Ward
authors.forename: A
authors.initials: A
authors.lastname: Simpson
authors.forename: V
authors.initials: V
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000592:standards*; D019091:Critical Pathways; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D059039:Standard of Care; D055815:Young Adult