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Reducing Mortality From Sepsis

I spent the day today with 60 physicians and nurses at a symposium focused on quality improvement and reducing mortality from sepsis.  Sepsis (overwhelming infection) is the number 1 cause of hospital deaths and the mortality rate can be as high as 60% if the patient goes into shock from infection.  Survival depends upon thousands of independent pieces coming together in an organized way.  A patient doesn’t come to the emergency department and say “I have sepsis”.  He may arrive by ambulance or be brought in by a relative and simply feel weak, or confused or have a fever.

To make the diagnosis, the doctor or nurse has to be thinking sepsis is a possibility and it is critical to get the right tests and treatments within a very short time frame.  There are complicated steps that must be taken quickly and the entire hospital team (lab, pharmacy, transport, doctors and nurses) must act in a coordinated way to treat the patient with the right tests, antibiotics, and massive fluids.  None of this happens without processes being put into place and that is where quality improvement teams come in.

It is so gratifying to see my clinical colleagues spending their precious time learning ways to improve the quality of care of our patients.  No-one gets paid to go to these conferences and quality improvement takes a lot of time and effort.  I believe our patients would be surprised to know how dedicated we are to improving hospital care and when a patient with sepsis is discharged to resume their normal life, how much teamwork went into that successful outcome.

Addendum: Although I like to refrain from politics on this blog, I couldn’t help but contrast the selflessness of my colleagues today, focusing their precious time (for no pay) on improving patient care, with the shocking Tea Party GOP debate where Texan Ron Paul and his audience supporters believe a 30 year old should die in a hospital rather than have any government funded health care.  It’s every man for himself.

*This blog post was originally published at EverythingHealth*

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2 Responses to “Reducing Mortality From Sepsis”

  1. David Marx, MD FACEP says:

    I appreciate your article on Sepsis but do NOT appreciate your political comment at the end. In it, you reveal incredible ignorance regarding the economy, selfishness with regard to the generations to come who will never be able to pay for the current indulgence of the liberal political class now in power. You have no idea who the Tea Party is, what it represents and what their message is.

  2. Ben says:

    Although I probably am politically closer to Dr. Brayer than Dr Marx on this one, it should be pointed out that Ron Paul did not say that the 30 year old coma patient should die. When some in the audience cheered for implication that the uninsured should be allowed to die, he chastened them and said:

    ——————————– QUOTE ——————————–
    “No. I practiced medicine before we had Medicaid, in the early 1960s, when I got out of medical school. I practiced at Santa Rosa Hospital in San Antonio , and the churches took care of them. We never turned anybody away from the hospitals… And we’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves. Our neighbors, our friends, our churches would do it. This whole idea, that’s the reason the cost is so high.

    The cost is so high because they dump it on the government, it becomes a bureaucracy. It becomes special interests. It kowtows to the insurance companies and the drug companies, and then on top of that, you have the inflation. The inflation devalues the dollar, we have lack of competition.

    There’s no competition in medicine. Everybody is protected by licensing. And we should actually legalize alternative health care, allow people to practice what they want.”
    —————————— END QUOTE ——————————

    This answer is to some degree a cop-out, especially considering his earlier comments about freedom and risk, but he was arguing that medical providers and communities need to show exactly those traits that you were praising in your colleagues: selflessness and the need to work – sometimes unpaid – to do the right thing for your patients.

    Regardless, I don’t think it helps the political discourse to have each side so eager to (mis)construe every sound byte no matter how out of context. The tea party has more than its share of know-nothings (no question about that), but let’s not pretend that it’s composed solely of blood-thirst hooligans with no regard for fellow citizens.

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