Life-threatening sepsis must be treated within the hour, says NICE
The National Institute for Health and Care Excellence (NICE) is urging hospital staff to treat people with life-threatening sepsis symptoms within one hour.
In a new draft quality standard on sepsis, NICE says anyone identified as high-risk should be reviewed immediately by a senior clinical decision-maker, who can be a nurse practitioner with antibiotic prescribing responsibilities if the patient is over 18.
Patients should receive antibiotics and intravenous fluid treatment within one hour. If it will take them more than one hour to arrive at a hospital, antibiotics can be given in GP practices or by ambulance staff.
‘Sepsis is a medical emergency and needs immediate senior review to identify the source of infection and ensure that people receive appropriate treatment,’ the draft guidance states.
‘A senior decision-maker is also more likely to recognise if there is another potential cause for the person’s severe illness.’
The review includes details on recording vital signs, such as temperature and heart rate, as well as on checking for rashes and skin discolouration.
The recommendation that a nurse practitioner should lead the review applies only to patients aged over 18 in acute hospital settings.
For children aged 5-17, the review recommends that a paediatric or emergency care grade doctor perform the review, while for under fives it recommends a paediatric doctor only.
NICE deputy chief executive Gillian Leng said: ‘We know from recent case reviews that there are inconsistencies in how people’s symptoms are assessed in different settings.
‘More can be done to provide rapid treatment.’
The 2015 report by the National Confidential Enquiry into Patient Outcome and Death claimed 40% of people admitted to A&E with sepsis did not have a timely review by a senior clinician.
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