pivotal role of dispatch in sepsis emergencies · the pivotal role of dispatch in sepsis...
TRANSCRIPT
The Pivotal Role of Dispatch in Sepsis Emergencies
February 6, 2019
Rommie L. Duckworth, LPFounder/Executive Director
New England Center for Rescue & Emergency Medicine, LLC
Today’s Objectives
Upon completion of this webinar, participants will be able to: ▪ Define sepsis and the symptoms and conditions in which
sepsis should be suspected▪ Describe why suspected sepsis is an emergency event▪ Ask the right questions of the caller to identify suspected
sepsis▪ Convey precise information to the ambulance team▪ Share/train other dispatchers in their unit to improve
response to sepsis
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It’s Not Always Sepsis
Sepsis
Sepsis is an infection
Sepsis is rare
Sepsis only affects the very sick / old
They’ll find it at the hospital
Sepsis
Sepsis
The body’s overwhelming and life-threatening response
to infection which can lead to tissue damage, organ failure, and death.
Acquired infection
Blood vessel problems
Circulatory collapse
270,000
prostate cancer, breast cancer and AIDS
combined
Leading cause death
Leading cause readmission
$27 BillionIncreasing 6.25%
25-30%
40-70%
4 heart attack
10Severe Sepsis
EMS Transports 50%of patients with severe sepsis
arriving at the ED
Those patients tend to be older and sicker
EMS tends to be first medical contact since .
87%of sepsis cases begin in the community
prior to hospitalization
Understand
Improve
Coordinate
Learn ABCs
Use
Be
Prehospital Sepsis Alert
decreased time to treatment
30-60 minutes
13.6% vs 26.7%
Cell damage from infection Chemical signal release • Vasodilation • Increase blood flow• Increased permeability• Increased metabolism
Inflammatory Response
SICK
SIRSSystemic Inflammatory Response Syndrome
Burns, Trauma, Pancreatitis, Ischemia
Infection
SIRSCell damage from infection Chemical signal release Triggered inflammatory response
• Vasodilation• Increased permeability• Increased metabolism• Cellular damage• Hemorrhage• Clotting & DIC
SIRSTwo or more of the following in adults:
• Temperature > 38 C (100.4 F) or < 36 C (96.8 F)• Heart rate > 90 beats per minute• Respiratory rate > 20 breaths per minute or PaCO2 <32 mmHg• WBC > 12,000 cell/mm3, <4,000 cell/mm3, or >10% immature forms
Acquired infection
Blood vessel problems
Circulatory collapse
Follow the Patient’sCHART
CHART
CHART
Acquired infection
Blood vessel problems
Circulatory collapse
Acquired infection
BC
Complaints
Common Sites of Primary Infection
CHART
History
Risk Factors
Risk Factors
Risk Factors
CHART
ABlood vessel problems
C
Assessment
Assessment
Assessment
Assessment
0.00%
10.00%
20.00%
30.00%
40.00%
< 95 F 98.6 F - 100.9F
100.9 F - 103.1F
> 103.1 F
Patient Temp vs % Sepsis Mortality
CHART
A BCirculatory collapse
Code Sepsis
Sepsis Alert
ONE SIZE DOES NOT
FIT ALL
Sensitivity
My SA Criteria
Bad Vitals =
Bad Vitals =
Bad Vitals =
Bad Vitals =
CHART
ABCs
Understand
Improve
Coordinate
Acquired infection
Blood vessel problems
Circulatory collapse
CHART
SEPSIS ALERT
Code Sepsis
Sepsis Alert
Be Heard
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How to Get Involved
Thank You for Attending
Please complete the evaluation provided at the end of the webinar.
Visit our website at:
Great Plains Quality Innovation Network
https://greatplainsqin.org/
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Great Plains QIN Sepsis Team
North Dakota: Nikki Medalen, MS, BSN, [email protected]
(701) 989-6236
South Dakota: Katy Burket, RN
[email protected](605) 680-1161
Nebraska: Krystal Hays, DNP, RN, [email protected]
(402) 476-1399; Ext. 522
Kansas: Kara Irey, BS, GBSS
[email protected](785) 273-2552; Ext 365
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