publication . Article . 2018

Poor Compliance with Sepsis Guidelines in a Tertiary Care Children’s Hospital Emergency Room

Benjamin Louis Moresco; Benjamin Louis Moresco; Clinton Woosley; Clinton Woosley; Morris Sauter; Utpal Bhalala; Utpal Bhalala;
Open Access
  • Published: 01 Apr 2018 Journal: Frontiers in Pediatrics, volume 6 (eissn: 2296-2360, Copyright policy)
  • Publisher: Frontiers Media SA
Abstract
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support (PALS) guidelines for severe sepsis and septic shock (SS) in an emergency room (ER) of a tertiary care children’s hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children’s Hospital of San Antonio (CHofSA) ED over one year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "septic shock." Patients in the adherent group were those who met all 3 elements of adherence: 1) rapid vascular access with at most 1 IV attempt before seeking alternate access...
Subjects
free text keywords: Septic shock, medicine.disease, medicine, Guideline, Intensive care medicine, medicine.medical_specialty, Diagnosis code, Sepsis, business.industry, business, Organ dysfunction, medicine.symptom, Pediatric advanced life support, Internal medicine, Triage, Resuscitation, Pediatrics, Original Research, severe sepsis, management, adherence, guidelines, RJ1-570
23 references, page 1 of 2

1 Hartman ME Linde-Zwirble WT Angus DC Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med (2013) 14(7):686–93.10.1097/PCC.0b013e3182917fad 23897242 [OpenAIRE] [PubMed] [DOI]

2 Carcillo JA. Pediatric septic shock and multiple organ failure. Crit Care Clin (2003) 19(3):413–40.10.1016/S0749-0704(03)00013-7 12848313 [OpenAIRE] [PubMed] [DOI]

3 Paul R Neuman MI Monuteaux MC Melendez E. Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics (2012) 130(2):e273–80.10.1542/peds.2012-0094 22753559 [OpenAIRE] [PubMed] [DOI]

4 Weiss SL Fitzgerald JC Pappachan J Wheeler D Jaramillo-Bustamante JC Salloo A Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med (2015) 191(10):1147–57.10.1164/rccm.201412-2323OC 25734408 [OpenAIRE] [PubMed] [DOI]

5 Weiss SL Fitzgerald JC Maffei FA Kane JM Rodriguez-Nunez A Hsing DD Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study. Crit Care (2015) 19:325.10.1186/s13054-015-1055-x 26373923 [OpenAIRE] [PubMed] [DOI]

6 de Caen AR Berg MD Chameides L Gooden CK Hickey RW Scott HF Pediatric advanced life support 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation (2015) 132(Suppl 2):S526–42.10.1161/CIR.0000000000000266 26473000 [OpenAIRE] [PubMed] [DOI]

7 Dellinger RP Levy MM Rhodes A Annane D Gerlach H Opal SM Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med (2013) 41:580–637.10.1097/CCM.0b013e31827e83af 23353941 [PubMed] [DOI]

8 Paul R Melendez E Stack A Capraro A Monuteaux M Neuman MI. Improving adherence to PALS septic shock guidelines. Pediatrics (2014) 133(5):e1358–66.10.1542/peds.2013-3871 24709937 [OpenAIRE] [PubMed] [DOI]

9 Goldstein B Giroir B Randolph A International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med (2005) 6(1):2–8.10.1097/01.PCC.0000149131.72248.E6 15636651 [OpenAIRE] [PubMed] [DOI]

10 Nakagawa S Shime N Respiratory rate criteria for pediatric systematic inflammatory response syndrome. Pediatr Crit Care Med (2014) 15(2):182 10.1097/PCC.0000000000000024 24492191 [PubMed] [DOI]

11 Inwald DP Tasker RC Peters MJ Nadel S Paediatric Intensive Care Society Study Group (PICS-SG)Emergency management of children with severe sepsis in the United Kingdom: the results of the paediatric intensive car e society sepsis audit. Arch Dis Child (2009) 94(5):348–53.10.1136/adc.2008.153064 19131419 [PubMed] [DOI]

12 Puskarich MA Marchick MR Kline JA Steuerwald MT Jones AE One year mortality of patients treated with an emergency department based early goal-directed therapy protocol for severe sepsis and septic shock: a before and after study. Crit Care (2009) 13(5):R167 10.1186/cc8138 19845956 [OpenAIRE] [PubMed] [DOI]

13 Trzeciak S Dellinger RP Abate NL Cowan RM Stauss M Kilgannon JH Translating research to clinical practice: a 1-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest (2006) 129(2):225–32.10.1378/chest.129.2.225 16478835 [OpenAIRE] [PubMed] [DOI]

14 Crowe CA Mistry CD Rzechula K Kulstand CE Evaluation of a modified early goal directed therapy protocol. Am J Emerg Med (2010) 28(6):689–93.10.1016/j.ajem.2009.03.007 20637384 [PubMed] [DOI]

15 Jones AE Focht A Horton JM Kline JA Prospective external validation of the clinical effectiveness of an emergency department based early goal-directed therapy protocol for severe sepsis and septic shock. Chest (2007) 132(2):425–32.10.1378/chest.07-0234 17573521 [OpenAIRE] [PubMed] [DOI]

23 references, page 1 of 2
Abstract
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support (PALS) guidelines for severe sepsis and septic shock (SS) in an emergency room (ER) of a tertiary care children’s hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children’s Hospital of San Antonio (CHofSA) ED over one year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "septic shock." Patients in the adherent group were those who met all 3 elements of adherence: 1) rapid vascular access with at most 1 IV attempt before seeking alternate access...
Subjects
free text keywords: Septic shock, medicine.disease, medicine, Guideline, Intensive care medicine, medicine.medical_specialty, Diagnosis code, Sepsis, business.industry, business, Organ dysfunction, medicine.symptom, Pediatric advanced life support, Internal medicine, Triage, Resuscitation, Pediatrics, Original Research, severe sepsis, management, adherence, guidelines, RJ1-570
23 references, page 1 of 2

1 Hartman ME Linde-Zwirble WT Angus DC Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med (2013) 14(7):686–93.10.1097/PCC.0b013e3182917fad 23897242 [OpenAIRE] [PubMed] [DOI]

2 Carcillo JA. Pediatric septic shock and multiple organ failure. Crit Care Clin (2003) 19(3):413–40.10.1016/S0749-0704(03)00013-7 12848313 [OpenAIRE] [PubMed] [DOI]

3 Paul R Neuman MI Monuteaux MC Melendez E. Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics (2012) 130(2):e273–80.10.1542/peds.2012-0094 22753559 [OpenAIRE] [PubMed] [DOI]

4 Weiss SL Fitzgerald JC Pappachan J Wheeler D Jaramillo-Bustamante JC Salloo A Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med (2015) 191(10):1147–57.10.1164/rccm.201412-2323OC 25734408 [OpenAIRE] [PubMed] [DOI]

5 Weiss SL Fitzgerald JC Maffei FA Kane JM Rodriguez-Nunez A Hsing DD Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study. Crit Care (2015) 19:325.10.1186/s13054-015-1055-x 26373923 [OpenAIRE] [PubMed] [DOI]

6 de Caen AR Berg MD Chameides L Gooden CK Hickey RW Scott HF Pediatric advanced life support 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation (2015) 132(Suppl 2):S526–42.10.1161/CIR.0000000000000266 26473000 [OpenAIRE] [PubMed] [DOI]

7 Dellinger RP Levy MM Rhodes A Annane D Gerlach H Opal SM Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med (2013) 41:580–637.10.1097/CCM.0b013e31827e83af 23353941 [PubMed] [DOI]

8 Paul R Melendez E Stack A Capraro A Monuteaux M Neuman MI. Improving adherence to PALS septic shock guidelines. Pediatrics (2014) 133(5):e1358–66.10.1542/peds.2013-3871 24709937 [OpenAIRE] [PubMed] [DOI]

9 Goldstein B Giroir B Randolph A International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med (2005) 6(1):2–8.10.1097/01.PCC.0000149131.72248.E6 15636651 [OpenAIRE] [PubMed] [DOI]

10 Nakagawa S Shime N Respiratory rate criteria for pediatric systematic inflammatory response syndrome. Pediatr Crit Care Med (2014) 15(2):182 10.1097/PCC.0000000000000024 24492191 [PubMed] [DOI]

11 Inwald DP Tasker RC Peters MJ Nadel S Paediatric Intensive Care Society Study Group (PICS-SG)Emergency management of children with severe sepsis in the United Kingdom: the results of the paediatric intensive car e society sepsis audit. Arch Dis Child (2009) 94(5):348–53.10.1136/adc.2008.153064 19131419 [PubMed] [DOI]

12 Puskarich MA Marchick MR Kline JA Steuerwald MT Jones AE One year mortality of patients treated with an emergency department based early goal-directed therapy protocol for severe sepsis and septic shock: a before and after study. Crit Care (2009) 13(5):R167 10.1186/cc8138 19845956 [OpenAIRE] [PubMed] [DOI]

13 Trzeciak S Dellinger RP Abate NL Cowan RM Stauss M Kilgannon JH Translating research to clinical practice: a 1-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest (2006) 129(2):225–32.10.1378/chest.129.2.225 16478835 [OpenAIRE] [PubMed] [DOI]

14 Crowe CA Mistry CD Rzechula K Kulstand CE Evaluation of a modified early goal directed therapy protocol. Am J Emerg Med (2010) 28(6):689–93.10.1016/j.ajem.2009.03.007 20637384 [PubMed] [DOI]

15 Jones AE Focht A Horton JM Kline JA Prospective external validation of the clinical effectiveness of an emergency department based early goal-directed therapy protocol for severe sepsis and septic shock. Chest (2007) 132(2):425–32.10.1378/chest.07-0234 17573521 [OpenAIRE] [PubMed] [DOI]

23 references, page 1 of 2
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