An18-year-old woman (Janelle*) arrived one evening in a Meridian ER with a fever, a white count of 23.8, lab work indicating renal concerns, a heart rate that had climbed to 120, and a complaint of abdominal pain. On admission to the floor in the middle of the night, she was assessed as lethargic. An18-year-old woman (Janelle*) arrived one evening in a Meridian ER with a fever, a white count of 23.8, lab work indicating renal concerns, a heart rate that had climbed to 120, and a complaint of abdominal pain. On admission to the floor in the middle of the night, she was assessed as lethargic. *fictitious name
Throughout the day and evening, Janelle continued to deteriorate. Renal failure ensued. Disseminated intravascular coagulation developed and GI bleeding occurred. Aggressive treatment including drugs, blood, fluids, dialysis, intubation and mechanical ventilation all were attempted... But it was too late. Janelle died within a day of her arrival in our Meridian ED, on her 19th birthday. Throughout the day and evening, Janelle continued to deteriorate. Renal failure ensued. Disseminated intravascular coagulation developed and GI bleeding occurred. Aggressive treatment including drugs, blood, fluids, dialysis, intubation and mechanical ventilation all were attempted... But it was too late. Janelle died within a day of her arrival in our Meridian ED, on her 19th birthday.
By early morning, her heart rate continued at the high rate of 130 and now her BP was concerning at 84/40 and her rectal temp was sub-normal. It was not possible to even draw labs on her. Intravenous fluids and antibiotics were given but two hours later, her BP was only 60 and she was transferred to the intensive care unit at 8 a.m. By early morning, her heart rate continued at the high rate of 130 and now her BP was concerning at 84/40 and her rectal temp was sub-normal. It was not possible to even draw labs on her. Intravenous fluids and antibiotics were given but two hours later, her BP was only 60 and she was transferred to the intensive care unit at 8 a.m.
One of our own nurses noted: One of our own nurses noted: “The devastation and heartbreak that was felt by the team that did all they could do for her and couldn’t save her was secondary only to the heartbreak, devastation and anguish of her parents who lost a child that night.”
By reducing that rate by 20%, 1214 lives would be saved. By reducing that rate by 20%, 1214 lives would be saved. As such, we are part of a New Jersey collaborative to reduce sepsis mortality - Bold aims:
- Implement early recognition sepsis screening and treatment protocols in all NJ hospitals by December 2015
- Reduce severe sepsis mortality rates by 20% in NJ by December 2015
All coming to a place near you All coming to a place near you Multi-method: A variety of delivery methods will be used to get information out to bedside clinicians, including but not limited to: Huddles, HealthStream modules, Eye on Evidence newsletters, and webinar. - Call to Action – Early May 2015
- Core education on sepsis – Mid-May 2015
- Reminders and Refreshers – June through December 2015
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