Explorationof Sepsis Protocol in Emergency Department

Explorationof Sepsis Protocol in Emergency Department

Sepsisis a complication of an infection, which can be life-threatening. Itoccurs when chemical substances intended to fight an infection induceinflammatory effects in the body. This inflammation can cause aseries of changes that can harm the tissue, or harm organ systemsleading to their failure. According to Mayo Clinic, sepsis affects arange of groups of people such as the elderly, children, people withfrail immune systems, and people suffering from chronic illnesses,among others (MayoClinic, 2016).Besides, the Centers for Disease Control and Prevention indicatesthat more than 260,000 people die from sepsis each year withthousands of others surviving with severe after-effects in theirlives (CDC,2015). If sepsis develops to septic shock, there is a rapid drop in bloodpressure, which may cause death. The management of sepsis begins withan initial screening followed by the initial management in theEmergency Department (ED) through a set protocol. This paper seeks toexplore the sepsis management protocol in the ED. It focuses on aprospective observational study conducted on patients treated usingearly goal-directed therapy (EGDT) in the ED.

Descriptionof project design

Theproject design was a prospective observational study in nature. Itwas conducted between November 2005 and July 2008, having beensanctioned by the institutional review board and the privacy board ofthe healthcare system in Carolina (Studneket al., 2012).The patients were admitted in a teaching hospital located in an urbanarea. The healthcare organization received more than 100,000emergency medicine patients annually (Studneket al., 2012).The emergency department staff comprised of physicians and nursesunder the supervision of physicians certified by the board.

Populationof interest and stakeholders

Thepopulation of study for this project was emergency departmentpatients with severe sepsis. The project considered patients whoreceived emergency medical services (EMS) alongside those that didnot receive EMS before being subjected to EGDT. The eligibilitycriteria for these individuals was based on the following conditions.First, all the participants were above 17 years of age they musthave had a confirmed or suspected infection with a heartbeat rate of90 beats per minute, and a temperature range of between 36oCand 38oC.Moreover, their rate of respiration was required to average 20breaths every minute with an average blood pressure of 90 mm Hg(Studneket al., 2012).The major stakeholders for this study project were the privacy boardof the healthcare system in Carolina, the institutional review board,the healthcare organization in which the study was conducted, and theemergency medicine board.


Theboard of emergency medicine appropriately certified the emergencydepartment staff in this study. The personnel were required to haveworked in the emergency department before, with knowledge and skillsto handle severe sepsis (Studneket al., 2012).Furthermore, they were required to have the capacity to recognizegrave signs that could lead to disastrous outcomes and provide thenecessary interventions accurately. The emergency departmentpersonnel dealing with cases of sepsis are required to respond tocases immediately and decide on the action to take accurately. Inthat regard, the role of EMS in the sepsis protocol should not beoverlooked because it forms a vital facet of the initial management(Sweetet al., 2012).


Theproject utilized a range of tools that are used in a typicalemergency department. In particular, it utilized syringes and IVs fordrug administration, vital signs monitors, and nerve monitoringsystems, forceps and other instruments for holding body tissue.Similarly, it utilized the electronic hospital equipment for inputand analysis of patients` records (Nguyenet al., 2006).In addition, patient medical forms from the hospital were used torecord the findings and outcomes of different procedures.

Datacollection procedure

Clinicaloutcomes and other data were collected through observation of thepatients’ progress, and reviewing their medical background (Studneket al., 2012).Similarly, the ED personnel acquired direct responses from thepatients regarding their feelings at certain points in time. Most ofthis data was recorded in the hospital record forms for the patientsand the electronic patient form. The explanatory variables for theproject were gender, race, and age of the patient. The collected datawas analyzed using descriptive statistics such as frequencies andconfidence intervals, standard deviations and means. Unpaired t-testsand chi-square tests were used to assess other characteristics of thetrends portrayed by the data collected (Studneket al., 2012).


Itis clear that a significant proportion of patients with sepsis areadmitted into hospitals through the emergency department. This issimply because it is reasonable to initiate the management of thecondition in this department to increase the survival chances, giventhe fact that time is vital. The project studied demonstrated thatEGDT in the emergency department reduces the likelihood of fatalitiesfrom sepsis. This supposition is reinforced by the outcomes of thestudy, whose success promotes inclusive effort from all stakeholdersto encourage a large number of survival cases from sepsis.


CDC.(2015). Sepsis. Retrieved July 16, 2016, fromhttp://www.cdc.gov/sepsis/

MayoClinic. (2016). Sepsis. Retrieved July 16, 2016, fromhttp://www.mayoclinic.org/diseases-conditions/sepsis/home/ovc-20169784

Nguyen,H. B., Rivers, E. P., Abrahamian, F. M., Moran, G. J., Abraham, E.,Trzeciak, S., … &amp Program, E. D. S. E. (2006). Severe sepsisand septic shock: review of the literature and emergency departmentmanagement guidelines.&nbspAnnalsof emergency medicine,&nbsp48(1),54-e1.

Studnek,J. R., Artho, M. R., Garner, C. L., &amp Jones, A. E. (2012). Theimpact of emergency medical services on the ED care of severesepsis.&nbspTheAmerican journal of emergency medicine,&nbsp30(1),51-56. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032016/

Sweet,D., Marsden, J., Ho, K., Krause, C., &amp Russell, J. A. (2012).Emergency management of sepsis: The simple stuff saves lives.&nbspBCMed J,54,176-182.