The Academy of Medical Royal Colleges has released new national guidelines to address the way that healthcare professionals, including nurses, treat sepsis. The Statement on the initial antimicrobial treatment of sepsis proposes a change in the way people with suspected severe infection (sepsis) are treated with antibiotics.
"Sepsis still kills far too many people each year, tens of thousands every year throughout the UK and we know that if caught early, some cases of sepsis are preventable or treatable."
Having the right treatment for sepsis requires:
- The person to be seen by a healthcare professional. Often people in the early stages of sepsis do not consider themsleves ill enough to seek medical help.
- The healthcare professional must recognise the person culd potentially be seriously ill and could have sepsis. The early signs of sepsis are mild and can be similar to other illnesses, therefore recognising the early signs can be difficult.
- The patient must be transferred to an acute hospital
- Basic support must be provided by the clinical team, such as giving extra fluid to increase blood pressure or assisting breathing by giving oxygen. Tests must also be performed in order to find out why the person is ill.
- If the cause of the illness is infection, anitbiotics must be given promptly. Once test results are available, the antibiotics must be changed or stopped accordingly.
Treating sepsis with the right antibiotics is crucial, however test results might not always be readily available to identify the responsible microbe.
The new guidance proposes that the updated National Early Warning Score (version 2, NEWS2) should be used to supplement clinical judgement to identify adult patients with suspected sepsis who are critically ill and need treatment quickly. Through research evidence and clinical experience, the AoMRC determined how quickly the person needs to be assessed, and the circumstances under which there was time to perform more tests to decide what treatment they needed. The higher scores reflect the need for a quick assessment and antbiotic treatment. The AoMRC's suggestion allow healthcare professionals more time to find out what the best treatment is for the person. There is some flexibility on this, and healthcare professionals need to use their own judgment and consider other factors, as well as adopt the treatment to patient or parental preferences.
The recomendations in the new guidance document "must be prospectively checked to confirm they do improve care for people with sepsis" through local audits and cross-hospital research.
To read the new guidance in full, please visit aomrc.org.uk
To better understand how you can improve antibiotic prescribing for critically ill patients with suspected sepsis, and to network with colleagues who are working to improve practice in the recognition and management of Sepsis, join our Sepsis: Improving Practice during and beyond Covid-19.
