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Draft guidance issued to speed up sepsis treatment

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Hospital nurses should suspect sepsis if a patient presents with signs or symptoms that indicate possible infection, even if they do not have a high temperature, according to latest draft guidance.

Clinicians should also take into account that people with sepsis may have non-specific, non-localised presentations, for example feeling very unwell.

“We want all healthcare professionals to see sepsis as an immediate life-threatening condition”

Mark Baker

In addition, they should pay particular attention to concerns expressed by the person and their family or carers, for example changes from usual behaviour.

These recommendations for part of new draft guidance published today by the National Institute for Health and Care Excellence, which when finalised are designed to speed up the recognition and treatment of sepsis.

NICE noted that over 123,000 people in England suffered from sepsis last year and it is estimated to kill around 37,000 people each year. However, it pointed to evidence that clinicians struggled to identify it early enough in some cases, resulting in preventable death.

According to a recent audit, which studied a sample of 3,363 patients from 305 hospitals in 2014, there was a delay in identifying sepsis in 36% of cases, severe sepsis in 51.5% and septic shock in 32.6%.

The National Confidential Enquiry into Patient Outcome and Death report also found 33.8% of hospitals studied had no formal sepsis protocol.

NICE said its new draft guideline would help healthcare professionals “working in any NHS setting to recognise sepsis so they can provide early treatment”.

However, it noted that the signs and symptoms of sepsis “can vary and may be subtle which can lead to it being missed if it is not considered early on”.

“The development of this new guideline will be a valuable addition to the ongoing work the NHS is under taking to tackle this serious condition”

Celia Ingham

The draft guidance sets out what signs and symptoms to look out for, how to identify those at high risk of developing sepsis and which clinical tests to use to diagnose and monitor.

As well as recognition and diagnosis, it covers the early management of the condition, including the appropriate use of antibiotics and other supportive treatments such as fluids and oxygen.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: “We want all healthcare professionals to see sepsis as an immediate life-threatening condition and make sure there are systems in place across the NHS for it to be recognised and treated as an emergency.

“This new guideline will be the first to provide evidence-based best practice advice on how to quickly identify and treat people with sepsis,” said Professor Baker.

He added: “We now urge all healthcare professionals and organisations with an interest in this area to comment on the proposed recommendations.”

Celia Ingham Clark, NHS England’s national director for reducing premature deaths, said it had recently published a new system-wide action plan to ensure healthcare professionals were supported and equipped to identify and treat sepsis early.

The development of the NICE guideline will be a “valuable addition to the ongoing work the NHS is under taking to tackle this serious condition”, she said.

The draft version of the institute’s guideline has been published for consultation until 5pm on 22 February.

Organisations can register as a stakeholder on the NICE website. Individuals are ideally advised to pass comments through a registered stakeholder organisation that most closely represents them.


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Readers' comments (1)

  • Marc Evans

    Sepsis triggers have been built into our NEWS charts recently, it prompts us to recognise possible signs and act on them early.

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