Pediatric ED sees 76% drop in missed sepsis diagnoses due to new protocol

A study, published in the Annals of Emergency Medicine, shows an electronic alert for sepsis helped a pediatric emergency department significantly reduce missed sepsis diagnoses.

The study examined the impact of a two-stage alert, developed by researchers and implemented in the hospital's EHR system. When an age-based elevated heart rate or hypotensive blood pressure is documented in the EHR at any time in the ED, the first-stage alert is triggered, which provides a series of questions about underlying high risk conditions, perfusion and mental status. The second-stage alert is triggered if any of the answers to the questions are in the affirmative.

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If patients trigger both stage alerts, a sepsis huddle is triggered, which involves a focused patient evaluation and discussion with the emergency physician and care team.

The study shows of the 1.2 percent of pediatric ED patients who triggered the two-stage alert, 23.8 percent experienced the sepsis huddles and underwent sepsis treatment.

The new sepsis protocol only missed 4 percent of patients, who went on to develop severe sepsis.

"Sepsis is a killer and notoriously difficult to identify accurately in children, which is why this alert is so promising," said lead study author Fran Balamuth, MD, PhD, of Children's Hospital of Philadelphia.

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