The dangers of sepsis are not known by many people. However just in 2011, New York State there were 43,608 sever cases of sepsis. This is a significant increase from 2005 where there were 6,001 cases. Misdiagnosis by doctors has been attributed to the increase in the number of cases. Despite sepsis being the leading cause of death in United States hospitals and is a major cause of medical costs many hospitals are not required to implement sepsis protocols. New York however is about to become the first state to require all hospitals to adopt protocols that are meant to identify and treat sepsis early which will hopefully prevent any further increase in the number of sepsis cases and eventually bring the number down.
These new protocols are called “Rory’s Regulations.” They were named after a twelve year old boy, Rory Staunton, from Queens. He died last year from sepsis after his arm was cut from playing basketball. Rory went to the emergency room because he was suffering from high fever, mottled skin, and a sore leg. At the emergency room he was released without receiving any of the blood tests that would have detected the infection and possibly have saved his life. He was misdiagnosed as having the stomach flu.
For successful treatment of sepsis there needs to be rapid diagnosis and management. Under the new regulations the best practices are:
- To within an hour of diagnosis of sepsis, to administer antibiotics and fluid resuscitation, and
- In cases of severe sepsis, have a full implementation of sepsis protocols within three hours, and in cases of septic shock, full implementation within six hours.
However there is some flexibility in that different facilities can select the protocols that work for them. The Department of Health must approve the protocols prior to their implementation. They also must be updated periodically ad provided by trained staff. Hospitals are also required under the regulations to collect data for their own improvement purposes as well as reporting to the Department of Health so that compliance with the regulations can be ensured. In cases of pediatric care, doctors are required to communicate critical tests results to parents in terms that can be easily understood prior to the discharge of the child from the hospital. Additionally, all test results need to be forwarded to the primary care provider.
It has been estimated that the regulations will take effect in May. After that hospitals will be required to submit their protocols to the State Health Department prior to July 1st so that they can be reviewed. Once protocols are approved they need to be implemented within 45 days.
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