Sepsis

Comments on Severe Sepsis and Septic Shock: Early Management Bundle (SEP-1)

Sept. 9, 2021: ACEP signed on to a letter to the National Quality Forum calling on SEP-1 NOT to be re-endorsed unless it is revised. ACEP is joined in this endorsement by Infectious Diseases Society of America, American Hospital Association, the Pediatric Infectious Disease Society, Society for Healthcare Epidemiology of America, Society of Hospital Medicine, and Society of Infectious Disease Pharmacists.

The comment letter suggests revisions that would accomplish the following goals:

Focus the bundle on the subset of patients most likely to benefit from rapid and aggressive interventions, i.e., those with septic shock, not those without shock
Minimize antibiotic overuse and adverse effects by eliminating patients with sepsis without shock from the bundle, and redefining the goals for time to antibiotic delivery
Eliminate bundle elements that do not contribute to improved patient outcomes, such as measuring serial lactates
Streamline the reporting process to focus on clinical outcomes
Make reporting electronic with data that is easily extractable from the electronic health record
Get input and support for intended changes from all the professional organizations that are most affected by the measure

View the full comment letter that goes into greater detail on each of these goals.

Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task Force Report

In April, the multispecialty task force convened by ACEP in 2019 published its new sepsis guidelines, “Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task Force Report” in Annals of Emergency Medicine. The report covers principles of early sepsis recognition, initial care steps in the ED and out-of-hospital environments, titration of care and related controversies. It has been endorsed by the American Academy of Emergency Medicine, the American College of Osteopathic Emergency Physicians, the American Osteopathic Board of Emergency Medicine, the Association of Academic Chairs of Emergency Medicine, the Council of Emergency Medicine Residency Directors, the Emergency Medicine Residents’ Association, the Emergency Nurses Association, the National Association of EMS Physicians, the Infectious Diseases Society of America, the Society for Academic Emergency Medicine, the Society of Critical Care Medicine, and the Society of Hospital Medicine.

Note: The DART tool has been updated to reflect these new guidelines. Developed by the ACEP Expert Panel on Sepsis.