Children's Hospital of Richmond (Va.) at VCU Health implemented mandatory sepsis screenings in the emergency department for all patients with a fever — an effort that has significantly decreased the hospital's potentially deadly sepsis cases.
As this season's pediatric flu death toll continues to rise across the country, these deaths could be linked to sepsis, a variable that led CHoR to introduce the mandatory ED sepsis screenings in January 2016.
The hospital's approach helped care providers identify previously undiagnosed sepsis cases. Nurses conduct the sepsis screening, which takes less than a minute. To identify early signs of sepsis, nurses look for abnormal vital signs, cold extremities, confusion, weak pulses and abnormal rashes.
If a patient has a positive score on the screening, which indicates they are at risk of having sepsis, nurses notify physicians. Physicians immediately treat patients suspected of having sepsis in what Jonathan Silverman, MD, emergency medicine specialist at CHoR, calls the "golden hour," where care providers administer IV antibiotics and fluids.
CHoR reported no missed cases of sepsis the first six months after introducing the screenings, Dr. Silverman said. During the last two years, the hospital reported only a few cases of children who did not have positive scores on the screening and developed sepsis.
Dr. Silverman and the CHoR team are continuing to highlight the benefits of rapid screenings and treatment and promoting sepsis education for families.