Sepsis is a rare life threatening condition that can develop rapidly from what might be otherwise innocuous infections. Recognising it at an early stage among the huge number of ordinary infections can be a challenge even to experienced clinicians.
Sepsis affected 123,000 people in England in 2014, resulting in approximately 37,000 deaths. 70% of cases derived from an infection developed in the community. It is estimated that there is potential to reduce deaths by up to 10,000 per annum by the optimisation of care
The Sepsis toolkit provides a collection of tools, knowledge, and current guidance to support the identifying and appropriate management of patients with sepsis. The toolkit is aimed at GPs and healthcare professionals assessing people in the community with acute infection. The resources also include information for patients and those close to them to look for when concerned about a sudden deterioration in a person’s health in the presence of infection.
Clinical resources and guidance for practices
The Sepsis Trust has created a range of resources to support clinicians in delivering the NICE guidelines. Similarly, GP clinical systems are being equipped to support clinicians by including the physiological values considered abnormal in the NICE Sepsis Guidelines.
Sepsis Trust decision support tools
The following resources are based upon the NICE Sepsis Guidance CG51
- Sepsis Trust Toolkit
- National Early Warning Scoring system. Suggested by NCEPOD Report and others for potential use in General Practice, this has the value of providing a baseline recording of physiological variables and communicating risk and concern to secondary care colleague regarding sick adults. Its use as a screening tool in Primary Care is not established.
GP Clinical Systems
It is noted that all GP clinical systems have aide memoire and templates for the recording of physiology useful in the documentation patients who are unwell with infection. Although there has been no formal college input to the construction of these it is advised that clinicians consider use them. Their use is important not only in documenting the severely unwell with sepsis but also when recording when the signs of sepsis were absent and that appropriate safety netting has been given.
Ultimately it is hoped that these systems will also support the production of early warning scores, admission leaflets and patient / parent advice leaflets.
National reports and legislation
Below are some of the most significant national reports and documents relating to sepsis.
Significant national reports
International Definitions and NICE Guidance
Resources for patients and carers
This is a challenge for trained clinicians as the signs and symptoms can be varied and subtle at the onset of sepsis. Patients, parents and carers often ask what they should look out for.
The Sepsis Trust has produced a background document entitled 'What is Sepsis?'.
Resources for training and appraisal
Sepsis care and identification has been a focus of much attention with new definitions and guidelines. It is important that clinicians keep up to date.
There are scheduled events hosted by regional faculties, which feature sepsis treatment.
Sepsis Trust provides an educational toolkit that helps GPs understand the subject and new guidance.
Health Education England and E-learning for Health have produced a suite of e-learning which has been endorsed by the RCGP. This e-learning incorporates both the new definitions for sepsis and recent NICE guidance.
The PRIMIS audit tool allows clinicians to capture and audit their performance against the NICE guidance (CG160) Feverish Illness in Children under Five Audit Tool.
Background and information for commissioners
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