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Shown conducting a “Code Sepsis” drill in the ED of Glen Cove Hospital, applying new, more stringent criteria for sepsis diagnosis, from left, are Patricia Davis, RN,
John D’Angelo, MD, director of the ED, Lorraine Lehmann, PCA, Alfredo Benito, RN, and Evelyn Mulvaney, nurse manager.
An elderly man presents
at the Emergency
Department (ED) of
a North Shore-LIJ hospital.
He has a dry cough, a fever
of 101 degrees and his heart
rate is slightly elevated at 97.
He doesn’t feel well, but his
blood pressure is normal. He is
undergoing chemotherapy for
colon cancer and his last chemo
session was three weeks ago.
A few years ago, that
patient may have been triaged
and treated as nonemergent,
which means he may have
taken his place in line behind
cases that more clearly
required emergent attention.
All that has changed, however,
thanks to the health system’s
Surviving Sepsis Program that
began in 2008.
Sepsis is a lifethreatening
condition
that arises when a systemic
22 Summer 2012
Sepsis-Related Mortality
Reduced by 35 Percent
But the Work Is Just Beginning
By Thea Welch
inflammatory response to
infection or injury attacks
the body’s own tissues
and organs. Without
diagnosis and treatment,
it can proceed rapidly and
irrevocably to severe sepsis
(sepsis complicated by organ
dysfunction) and then septic
shock (acute circulatory
failure). In 2008, it was
the single greatest cause
of in-hospital mortality in
the health system; further,
North Shore-LIJ’s mortality
rates were statistically higher
than predicted, according to
HealthGrades.
As part of his no-tolerance
approach to preventable death,
North Shore-LIJ President
and Chief Executive Officer
Michael Dowling targeted sepsis
as a major problem to address.
That’s why, today, as soon
as the patient hits the door
to the ED, he is recognized
as a possible sepsis patient,
and everything speeds up. An
established sepsis treatment
algorithm is followed
immediately, including
drawing blood and ordering
tests, such as serum lactate
level (elevated serum lactate
is associated with increased
mortality in severe sepsis
patients). The staff begins
administering intravenous (IV)