A Message from Our Medical Director
Welcome to the GHS Sepsis Program. Our team is committed to providing the best possible care to our patients with sepsis. Our vision is to make sure that GHS provides the most up to date treatment of sepsis to our Greenville community and beyond. We also are committed to a process of continuous innovation to further inform the treatment of this challenging disease. This page will provide some basics about what sepsis is and what GHS is doing to improve outcomes in our patients.
What is Sepsis?
Sepsis is a clinical syndrome that develops as a response to a severe infection in the body. The resulting inflammation caused by the infection results in various systemic responses such as the dilation of, and increased leakage from, blood vessels. The spread of the infection can causes an increase in heart rate, respiratory rate, infection fighting blood cells, and temperature. This is called the systemic inflammatory response syndrome or “SIRS” for short. When these responses are severe enough they can result in low blood pressure (hypotension) and/or inadequate perfusion of tissues and organs in the body. Poor perfusion puts these organs and tissues at risk for damage from ischemia, or lack of adequate oxygen supply. This is referred to as severe sepsis. Septic shock is the most severe form of sepsis which occurs when this hypotension and/or inadequate tissue perfusion persists despite the administration of adequate intravenous fluids. The results can be serious and can include damage to multiple organs in the body and even death. Examples of common infections that can cause sepsis include pneumonia and urinary tract infections, but any severe infection has the potential to cause sepsis. Unfortunately, sepsis is not uncommon and has increased in recent decades. One national database in the United States estimated an annual rate of more than 1,665,000 cases of sepsis between 1979 and 2000. Significant mortality rates, ranging from 10 to 52 percent, are associated with sepsis. This, combined the increasing severity of sepsis in the United State, makes this a very deadly disease. Fortunately, there are highly effective evidence-based practices that can significantly impact outcomes for patients with sepsis.
What is GHS doing?
GHS is continuously and aggressively implementing evidence based best practices to ensure that our patients with sepsis receive comprehensive, up to date, and truly innovative care. We have a Sepsis committee team which meets monthly to review and improve our process. All patients that come through our emergency departments are screened for sepsis by screening for evidence of SIRS. If the presence of SIRS is confirmed, the patient is questioned regarding signs or symptoms of an infection. If there is evidence for infection the patient is diagnosed with sepsis and a sepsis specific protocol is immediately activated while the patient is still in triage. This results in a sped up process for getting these patients back to the treatment area and initiating appropriate diagnostics and early treatment. It also triggers a screening process to look for severe sepsis and septic shock. The single most important intervention for these patients is early treatment with appropriate antibiotics. Reducing the time to antibiotics has been proven to dramatically reduce mortality in septic patients. By implementing the processes described above, we have cut our time to antibiotics in half. This has resulted in greater than a 60% reduction in mortality for septic patients at Greenville Memorial Hospital. A similar process is used on patients that develop sepsis after admission to the hospital.
What does the future hold for Sepsis at GHS?
At GHS, we continue to look for new and innovative ways to reduce our time to antibiotics. Recently, we began an effort to identify and treat patients with sepsis pre-arrival to the hospital. We are working with our EMS colleagues to achieve this. EMS personnel have been trained to screen for sepsis and initiate early treatment with antibiotics in appropriate patients, thus further reducing time to antibiotics, and potentially further reducing mortality. We also are pursuing recognition as a certified sepsis center. With the success we have already achieved, and our ongoing commitment to improvement and innovation, we look towards the future confident that we will continue to perform to the highest level for our patients with sepsis. I would like to thank everyone involved in our efforts.
Robert Brevetta, DO
Sepsis Medical Director
Greenville Health System