Breaking News: New Jersey Next for Mandatory Sepsis Protocols!

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Rory Staunton Foundation welcomes New Jersey State Health Commissioner’s announcement on the implementation of mandatory sepsis protocols!

Following a number of meetings with Commissioner Bennett and her staff over the past few years we welcome the Commissioner’s statement “while sepsis protocols have been an increasing focus of New Jersey hospitals, we know early identification and prompt treatment of sepsis is critical to survival. Every minute counts.” Today we thank the Commissioner for her action on changing regulations so that sepsis protocols will become mandatory in New Jersey.

Last December one of our delegations included New Jersey resident and sepsis survivor and National Family Council member Nicole Taylor who told her story of near death from sepsis, Nicole along with her family and others have been working furiously to secure mandatory protocols in the State.

The regulations are open to public comment from now until August 18th.

Read the NJ Spotlight article here

USA Today: ‘Rory’s Regs’ On Sepsis Require Hospital Checklists, Save Lives

USA Today, Sepsis, Rory Staunton Foundation, Rorys Regulations

By Jayne O’Donnell
Published by USA Today, May 22, 2017

New York regulations named after a 12-year-old victim of sepsis increased the chance of survival from the potentially deadly condition, a study out Sunday shows.

“Rory’s Regulations,” named for the late Rory Staunton of New York City, requires hospitals to quickly perform a checklist of safety measures when people show up at hospitals with sepsis.  A report in the New England Journal of Medicine Sunday found the faster hospitals completed the checklist of care and administered antibiotics, the lower the risk of death in hospitals from sepsis. With each additional hour it took, the risk of death increased 4%.

Sepsis, which occurs when the body’s response to an infection injures its own tissues and organs, is the biggest killer of hospital patients. More than 1.5 million cases of sepsis occur in the U.S. annually and more than 20% of people who contract sepsis die from it.

Rory Staunton died five days after falling and getting a cut on his arm in his school gym.

“This is an amazing policy that happened,” says University of Pittsburgh medical school assistant professor and physician Chris Seymour, lead author on the study.

“Minutes matter, and it is critical to perform the correct tests and get the patient antibiotics as fast as possible,” said co-author Mitchell Levy, a physician and professor at Brown University’s medical school.

Ciaran Staunton, Rory’s father, says he seldom uses this word but calls the findings “huge.”

“I have met a lot of the families saved in New York because they had to rule out sepsis,” says Staunton. “I’ve been to the grave sites in other states where there were no protocols.”

Read the original story on USA Today here.

Washington Post: Study Finds That Speeding Up Sepsis Care Can Save Lives

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By Lauran Neergaard May 21 at 3:04 PM
Published by Washington Post, May 21, 2017
WASHINGTON — Minutes matter when it comes to treating sepsis, the killer condition that most Americans probably have never heard of, and new research shows it’s time they learn. Sepsis is the body’s out-of-control reaction to an infection. By the time patients realize they’re in trouble, their organs could be shutting down. New York became the first state to require that hospitals follow aggressive steps when they suspect sepsis is brewing. Researchers examined patients treated there in the past two years and reported Sunday that faster care really is better.Every additional hour it takes to give antibiotics and perform other key steps increases the odds of death by 4 percent, according to the study reported at an American Thoracic Society meeting and in the New England Journal of Medicine.That’s not just news for doctors or for other states considering similar rules. Patients also have to reach the hospital in time.

“Know when to ask for help,” said Dr. Christopher Seymour, a critical care specialist at the University of Pittsburgh School of Medicine who led the study. “If they’re not aware of sepsis or know they need help, we can’t save lives.”

The U.S. Centers for Disease Control and Prevention last year began a major campaign to teach people that while sepsis starts with vague symptoms, it’s a medical emergency.

To make sure the doctor doesn’t overlook the possibility, “Ask, ‘Could this be sepsis?’” advised the CDC’s Dr. Lauren Epstein.

SEPSIS IS MORE THAN AN INFECTION

Once misleadingly called blood poisoning or a bloodstream infection, sepsis occurs when the body goes into overdrive while fighting an infection, injuring its own tissue. The cascade of inflammation and other damage can lead to shock, amputations, organ failure or death.

It strikes more than 1.5 million people in the United States a year and kills more than 250,000.

Even a minor infection can be the trigger. A recent CDC study found nearly 80 percent of sepsis cases began outside of the hospital, not in patients already hospitalized because they were super-sick or recovering from surgery.

THERE’S NO SINGLE SYMPTOM

In addition to symptoms of infection, worrisome signs can include shivering, a fever or feeling very cold; clammy or sweaty skin; confusion or disorientation; a rapid heartbeat or pulse; confusion or disorientation; shortness of breath; or simply extreme pain or discomfort.

If you think you have an infection that’s getting worse, seek care immediately, Epstein said.

WHAT’S THE RECOMMENDED CARE?

Doctors have long known that rapidly treating sepsis is important. But there’s been debate over how fast. New York mandated in 2013 that hospitals follow “protocols,” or checklists, of certain steps within three hours, including performing a blood test for infection, checking blood levels of a sepsis marker called lactate, and beginning antibiotics.

Do the steps make a difference? Seymour’s team examined records of nearly 50,000 patients treated at New York hospitals over two years. About 8 in 10 hospitals met the three-hour deadline; some got them done in about an hour. Having those three main steps performed faster was better — a finding that families could use in asking what care a loved one is receiving for suspected sepsis.

WHO’S AT RISK?

Sepsis is most common among people 65 and older, babies, and people with chronic health problems.

But even healthy people can get sepsis, even from minor infections. New York’s rules, known as “Rory’s Regulations,” were enacted after the death of a healthy 12-year-old, Rory Staunton, whose sepsis stemmed from an infected scrape and was initially dismissed by one hospital as a virus.

WHAT’S NEXT?

Illinois last year enacted a similar sepsis mandate. Hospitals in other states, including Ohio and Wisconsin, have formed sepsis care collaborations. Nationally, hospitals are supposed to report to Medicare certain sepsis care steps. In New York, Rory’s parents set up a foundation to push for standard sepsis care in all states.

“Every family or loved one who goes into a hospital, no matter what state, needs to know it’s not the luck of the draw” whether they’ll receive evidence-based care, said Rory’s father, Ciaran Staunton.

Copyright 2017 The Associated Press. All rights reserved.

Read the original article on The Washington Post here.

StatNews: Doctors Have Resisted Guidelines To Treat Sepsis. Those Guidelines Save Lives

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By Bob Tedeschi
Published by StatNews, May 21, 2017

Even in the face of increased pressure from regulators, many doctors have failed to fully embrace early screening and treatment protocols for sepsis, an infection-related complication that afflicts tens of thousands of Americans every year and that can be life-threatening.

Skeptics have argued that there haven’t been any comprehensive studies to support the notion that the protocols can actually save lives.

On Sunday, however, the New England Journal of Medicine published a large study that could make doctors reconsider — and help hospitals address head-on one of the most common dangers their patients face.

The study, involving more than 49,000 patients at 149 hospitals in New York state, suggests that for every hour that clinicians failed to complete the anti-sepsis protocols, known as the “three-hour bundle,” mortality rates climbed by between 3 percent and 4 percent.

“Our data shows that hospitals really need to do this at the outset, especially at the emergency department when they suspect sepsis,” said Dr. Christopher Seymour, a critical-care specialist at the University of Pittsburgh Medical Center, who led the study. “It can be lifesaving.”

Dr. Steven Q. Simpson, who leads critical care medicine at the University of Kansas Medical Center, and who was not involved in the study, said the analysis is “especially important” because it looks at one of only two states that have essentially mandated sepsis-prevention practices.

“This was every hospital in the state of New York, and they got in line with the regulations,” he said. “That is amazing.”

“I hope this helps convince people to follow suit.”

The protocols call on clinicians to first obtain a blood culture and measure the serum lactate level — often an indicator of septic shock, when the body’s immune system attacks vital organs — and to administer broad-spectrum antibiotics, usually by IV.

For a typical 40-year-old with septic shock, failure to follow these protocols increased the risk of death from 11 percent to 15 percent, according to the new study. For a 70-year-old with more than one serious illness, the risk of death increases from 29 percent to 38 percent.

Doctors who have already adopted the protocols and avoided treatment delays, according to proponents, have likely saved thousands of lives annually in New York alone, and could save tens of thousands nationally if the protocols are more widely adopted.

For now, though, the adoption rates remain spotty, according to Dr. Sean Townsend, an intensive-care doctor and researcher at Sutter Health in Northern California. Even the best-performing hospitals in the country, he said, comply with sepsis measures between 60 percent and 70 percent of the time.

Doctors and administrators who resist the protocols generally cite a few concerns: They fear that strict adherence to any protocol prevents doctors from exercising their best judgment with patients; others feel the protocols further deepens an emerging medical crisis around the overprescribing of antibiotics.

Some, like Dr. Mervyn Singer, professor of intensive care medicine at University College London, said that given the increase in antibiotic resistance, clinicians need more precise data about when such treatments are needed.

This study, he said, fails to provide that data.

He pointed out that while 23.6 percent of patients who did not complete the treatment protocols within three hours ultimately died, the proportion of patients who completed the protocols in the allotted time and also died was only marginally lower: 22.6 percent.

The study did not explain why some patients did not receive timely treatments, he said. But since most of the patients were elderly and possibly suffering from more than one chronic illness, he said, some may have had prolonged discussions with doctors about whether to aggressively treat a possible infection.

“I think a three-hour window is reasonable for treating most cases of sepsis, and some may benefit from more aggressive antibiotic treatment, he said. “But the idea that every hour makes a difference forces doctors to think they’re racing against time. And I’d argue that that three-hour window for some patients makes no difference whatsoever.”

A child’s case draws attention

The issue of sepsis was long ignored by many in the medical community, including in New York state.

In 2012, however, a 12-year-old New York boy, Rory Staunton, died from a sepsis infection that resulted from a scrape on his arm and that was poorly managed by hospital staff.

His case was later written about by New York Times columnist Jim Dwyer, and buoyed by that coverage and the attention it generated, New York state adopted “Rory’s Regulations” the following year. The regulations made New York the first state to require that all hospitals provide early screening and documentation for sepsis, and adopt sepsis-response protocols to guide treatment — most notably, by administering antibiotics within the first hour of diagnosis.

Then, in 2015, the Centers for Medicare and Medicaid Services, which oversees the nation’s government-run insurance programs, adopted new guidelines that compel all hospitals that accept federal funds — nearly all hospitals, that is — to track their adherence to the sepsis-management protocols. (The protocols are known as the “Severe Sepsis/Septic Shock Early Management Bundle,” or SEP-1, for short, and it largely mirrors the “three-hour bundle” protocols adopted by New York.)

Some critics point out that the protocols were instituted before a deep analysis of costs and benefits. One element of the protocols calls for rapid administration of IV fluids, for instance, and the new research shows no association between that step and lower mortality rates.

There can be significant burdens, in terms of staff responsibilities and hospital finances. Some hospitals have had to add staff to process antibiotic prescriptions more quickly, and the protocols require physicians to circle back to any patients with symptoms of sepsis.

And sepsis is trickier to diagnose than other conditions.

“Humans just like a yes or no answer, like with heart attacks: you have a test for it. Yes or no,” said Simpson, of the University of Kansas. “It’s not, ‘Well, first you have to look for abnormal vital signs, then organ dysfunction and if they’re hypotensive I’ll pay attention.’”

“If it’s a little complex to diagnose, like sepsis, you can have trouble getting people to do it.”

In some environments, hospital administrators may be unwilling to devote resources to something they don’t necessarily see as a problem.

Morris Miller, CEO, Xenex Disinfection Services, a San Antonio-based maker of disinfection robots, said that in recent years, hospitals have begun to respond to the issue of sepsis when faced with CMS penalties for high infection rates. But some retain attitudes similar to a hospital CEO he encountered in 2011.

“I was describing the cost savings that a hospital could achieve by avoiding infections. He laughed and said ‘It’s not very flattering but we still make money even when we make people sick.’”

‘Hospitals are finally starting to listen’

Many family members of those who have died of sepsis say their loved ones were doomed by clinicians who were overworked or negligent, or whose judgment was simply clouded with hubris.

Lisa Bartlett Davis lost her husband Jeff in 2012, roughly 24 hours after he checked himself into an Illinois hospital with a temperature of 104.6. He was told he had the flu and that he’d be discharged, despite his nurse’s verbal insistence that there was something else wrong.

“The doctor just blew her off,” Davis said.

After a shift change the next morning, her husband was in agony from the spreading infection. His blood pressure skyrocketed and a new doctor ordered tests of his spinal fluid. But Davis entered septic shock and died shortly after being transported to another hospital.

“We never found out the cause of the infection,” she said. “I still don’t know.”

Debbie Shearer’s son, George, faced even more troubling issues with his medical staff in Florida in early 2006 when he was recovering from surgeries following a car accident.

Hospital staff insisted that the 20-year-old shower, despite recovering from a craniotomy he had undergone to relieve pressure in his brain. Another staff person insisted on changing bandages on his legs as he sat on a toilet. When he started showing major signs of infection the next day – his legs turned black, among other symptoms – staff ignored the symptoms.

He languished for days in that hospital and in a subsequent rehabilitation facility before EMTs urged his mother to transport him to an acute care facility and an ICU. By the time he got there, his organs were failing. He later died.

“When I tried to explain to my dearest friends what happened, they said ‘Are you sure?’ There’s no way this could happen in our country,’” she said.

“Now I feel like hospitals are finally starting to listen, and realizing that not only does it help to save lives if you have protocols — because every minute counts, as we know —but it also saves on health care costs,” she said.

If researchers quibble with the timing threshold at which sepsis-prevention protocols should be mandated, Simpson said, patient stories like these reveal the wisdom of at least attempting quick responses.

“There’s nothing wrong with shooting for shorter, but it’s clearly a mistake to shoot for longer,” he said. “Because whatever goal you set, you’re going to miss sometimes. Look at this as if you’re a patient. Or it’s your mom and dad.”

Read the original StatNews article here.

CBS News: Aggressive treatment for sepsis can save lives, research shows

CBS News, Rory Staunton Foundation, Rory Staunton, Sepsis, Ciaran Staunton, Rorys Regulations, Sepsis Awareness, Sepsis, research

WASHINGTON — Minutes matter when it comes to treating sepsis, the killer condition that most Americans probably have never heard of, and new research shows it’s time they learn.

Sepsis is the body’s out-of-control reaction to an infection. By the time patients realize they’re in trouble, their organs could be shutting down.

New York became the first state to require that hospitals follow aggressive steps when they suspect sepsis is brewing. Researchers examined patients treated there in the past two years and reported Sunday that faster care really is better.

Every additional hour it takes to give antibiotics and perform other key steps increases the odds of death by 4 percent, according to the study reported at an American Thoracic Society meeting and in the New England Journal of Medicine.

That’s not just news for doctors or for other states considering similar rules. Patients also have to reach the hospital in time.

“Know when to ask for help,” said Dr. Christopher Seymour, a critical care specialist at the University of Pittsburgh School of Medicine who led the study. “If they’re not aware of sepsis or know they need help, we can’t save lives.”

The U.S. Centers for Disease Control and Prevention last year began a major campaign to teach people that while sepsis starts with vague symptoms, it’s a medical emergency.

To make sure the doctor doesn’t overlook the possibility, “Ask, ‘Could this be sepsis?'” advised the CDC’s Dr. Lauren Epstein.

Once misleadingly called blood poisoning or a bloodstream infection, sepsis occurs when the body goes into overdrive while fighting an infection, injuring its own tissue. The cascade of inflammation and other damage can lead to shock, amputations, organ failure or death.

It strikes more than 1.5 million people in the United States a year and kills more than 250,000.

Even a minor infection can be the trigger. A recent CDC study found nearly 80 percent of sepsis cases began outside of the hospital, not in patients already hospitalized because they were super-sick or recovering from surgery.

In addition to symptoms of infection, worrisome signs can include shivering, a fever or feeling very cold; clammy or sweaty skin; confusion or disorientation; a rapid heartbeat or pulse; confusion or disorientation; shortness of breath; or simply extreme pain or discomfort.

If you think you have an infection that’s getting worse, seek care immediately, Epstein said.

Doctors have long known that rapidly treating sepsis is important. But there’s been debate over how fast. New York mandated in 2013 that hospitals follow “protocols,” or checklists, of certain steps within three hours, including performing a blood test for infection, checking blood levels of a sepsis marker called lactate, and beginning antibiotics.

Do the steps make a difference? Seymour’s team examined records of nearly 50,000 patients treated at New York hospitals over two years. About 8 in 10 hospitals met the three-hour deadline; some got them done in about an hour. Having those three main steps performed faster was better — a finding that families could use in asking what care a loved one is receiving for suspected sepsis.

Sepsis is most common among people 65 and older, babies, and people with chronic health problems.

But even healthy people can get sepsis, even from minor infections. New York’s rules, known as “Rory’s Regulations,” were enacted after the death of a healthy 12-year-old, Rory Staunton, whose sepsis stemmed from an infected scrape and was initially dismissed by one hospital as a virus.

Illinois last year enacted a similar sepsis mandate. Hospitals in other states, including Ohio and Wisconsin, have formed sepsis care collaborations. Nationally, hospitals are supposed to report to Medicare certain sepsis care steps. In New York, Rory’s parents set up a foundation to push for standard sepsis care in all states.

“Every family or loved one who goes into a hospital, no matter what state, needs to know it’s not the luck of the draw” whether they’ll receive evidence-based care, said Rory’s father, Ciaran Staunton.

 

http://www.cbsnews.com/news/sepsis-syndrome-aggressive-treatment-saves-lives/

Stat News: Sepsis can send a child to the brink of death within hours

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Sepsis can send a child to the brink of death within hours. A new coalition of hospitals is fighting back

 

By Charlotte Huff
Published by Stat News, April 27, 2017

 

FORT WORTH, Texas — It might start out looking like not much more than an ordinary childhood fever.

But within days — within hours, sometimes — the complication known as sepsis can turn deadly. The patient’s blood pressure dives. Intense pain floods her body. Her organs begin to shut down.

The toll is frightening: Sepsis hospitalizes some 75,000 children and teens each year in the United States. Nearly 7,000 will die, according to one 2013 study. That’s more than three times as many annual deaths as are caused by pediatric cancers. And some of the children who survive sepsis may suffer long-term consequences, including organ damage and amputated limbs.

Now dozens of hospitals nationwide, including here in Fort Worth, are launching an all-out campaign against sepsis, an infection-related complication which can take hold after a viral illness — or an injury as innocuous as a scraped arm or a bug bite. Their ambitious goal: Reduce both childhood sepsis deaths and diagnoses of severe sepsis at participating hospitals by 75 percent by the end of 2020.

“You go big or you go home,” said Amy Knight, chief operating officer for the Children’s Hospital Association, which organized the sepsis collaboration.

The 44 hospitals participating in the effort so far — more are likely to join — have agreed to implement diagnostic and treatment protocols developed by dozens of experts. They will, for instance, screen all patients who show any signs that could be associated with sepsis and treat potential cases with quick infusions of antibiotics and intravenous fluids. And they’ll submit data on their cases to the collaboration — including how fast they got patients into treatment — in hopes of identifying best practices.

Some hospitals are also working on public education, such as teaching the warning signs of sepsis to parents of cancer patients, who are especially vulnerable to infection.

One key challenge: Training physicians and nurses to more quickly recognize the earlier stage, known as “warm sepsis,” which can masquerade as many other more common and far less worrisome childhood ills.

A child might develop a fever and a somewhat faster heart rate, but otherwise has good color and is chatting with the doctor. “And 10 minutes later, their blood pressure is out the bottom and they are in dire straits,” said Dr. Joann Sanders, chief quality officer at Cook Children’s Health Care System here in Fort Worth. “A kid who is well into sepsis is not that hard to recognize. That warm sepsis kid — that’s your challenge.”

A terrifying brush with death

Sepsis moved with terrifying speed in the case of Chloe Miller, who was diagnosed with septic shock last fall at age 12.

Chloe had gone to school near her home in Silver Spring, Md., that Friday with no signs of illness, although the teachers reported that she seemed somewhat tired, recounted her dad, Mark Miller. Her parents have learned to stay particularly attuned to even subtle changes in Chloe, who has autism and a seizure disorder and can’t communicate verbally.

By Saturday, the preteen was running a fever of 104 degrees. Acetaminophen did bring it down. But she was sleeping for long stretches, and becoming increasingly difficult to wake up. Alarmed, Chloe’s mother and grandmother decided to take her to a local emergency room late Saturday. They nearly had to carry her to the car.

The doctors and nurses there moved quickly, diagnosing Chloe with pneumonia and influenza and giving her antibiotics, intravenous fluids, and an escalating flow of oxygen for her alarmingly low blood pressure and oxygen readings, said Dr. Christiane Corriveau, the critical care physician who treated Chloe once she arrived by ambulance at Children’s National Medical Center in Washington, D.C., in the wee hours of Sunday morning. “I think everybody was concerned that this was more than just pneumonia — that her body was being taken over by the infection,” she said.

“When they said, ‘She’s out of the woods,’ it really hit me just how life-threatening this was.”
Mark Miller, parent

Despite the aggressive treatment, Chloe was already entering the final and most life-threatening stage of sepsis, called septic shock.

Miller distinctly recalls how unresponsive his daughter was in the intensive care unit, not flinching when she got a shot or an intravenous line. Also, that her breathing was unnervingly fast: “In and out and in and out and in and out.”

After getting blood and platelet transfusions, antibiotics, fluids and heart medications, among other treatments, Chloe was improving by Monday, Corriveau said. By Tuesday, her breathing had eased and her “blood pressures were beautiful.”

Miller, who works at Children’s National in a fundraising role, recalls lots of updates as clinicians combated his daughter’s low blood pressure and other symptoms. But it wasn’t until the worst of the crisis had eased that he first heard the word “sepsis” and learned what that diagnosis meant.

“When they said, ‘She’s out of the woods,’ it really hit me just how life-threatening this was,” he said.

A simple screening that can save lives

Sepsis, sometimes called blood poisoning, describes the body’s massive inflammatory response to an infection that infiltrates the blood stream. The body marshals all its efforts to protect the heart, lungs, and other vital organs, said Dr. Charles Macias, an emergency physician at Texas Children’s Hospital in Houston and one of the collaboration’s co-chairs.

A child’s heart rate typically increases, in order to pump more blood to boost oxygen levels to organs and other tissues, Macias said. The increased demand for oxygen speeds up his breathing. Blood pressure can drop, as some vessels may leak and others may dilate.

In 2012, a 12-year-old New York student named Rory Staunton developed sepsis and died several days after cutting his arm while playing basketball, heightening national attention to the issue. A few states, including New York, have since enacted protocols mandating that hospitals regularly screen patients for sepsis.  The Illinois version is dubbed Gabby’s Law, after a young girl who died from sepsis following a tick bite.

Some screening steps can be quite simple.

At Cook Children’s, a nurse will press down firmly on the child’s skin, for three seconds, said Stephanie Lavin, the hospital’s nurse quality leader for the sepsis initiative. The skin naturally turns lighter. But it should return to a normal shade within three seconds of releasing that pressure, she said. Any signs of poor blood flow — the jargon is capillary refill — indicates that the child is dehydrated or that blood has begun to shift away from the skin’s surface.

That skin check is part of Cook Children’s 18-point sepsis screening, a process that doesn’t take much longer than a minute and includes asking parents if their child has shown any signs of confusion. The screening is performed with any emergency room patient who complains of a fever or another symptom that could signal an underlying infection, such as abdominal pain.

Any child who scores 5 or higher on the 18-point scale gets oxygen, antibiotics, and intravenous fluids — even before the blood test results come back, according to Lavin. That turns out to be a lot of patients: About 150 to 190 a month in the ER are identified by that initial screen as potentially having sepsis.

Regular screening already is routine in some other departments, such as the surgery and cancer units. Beginning this spring, it will be expanded to nearly every unit of the hospital, Lavin said.

Some of the collaboration’s participants, including Cook Children’s, have already had been participating in smaller initiatives against sepsis. Other hospitals can join the national effort; the next deadline to sign up is June 30.

Rory’s mother, Orlaith Staunton, applauds the collaboration’s efforts. But she still advocates for a more standardized regulatory approach: She wants to require every hospital in the US to adhere to certain screening and treatment procedures.

Imagine, she said, that you’re driving down the road with an ill family member in the car. “This hospital happens to be very good at enforcing their own sepsis protocols. This one is not so good. I end up driving into the wrong hospital. Worst-case scenario, my child or my loved one dies,” said Staunton, who cofounded the Rory Staunton Foundation with her husband.

But Knight believes that the national collaborative model will work best, because it lets medical experts learn from one another. At Cook Children’s, for instance, doctors and nurses continue to tweak their screening system, in order to most rapidly flag that “warm sepsis” patient.

“Will we bring kids into the hospital and watch them overnight who don’t have sepsis?” asked Sanders, the chief quality officer. “Probably. But I’d rather do that to 90 kids and catch the 10 kids who are in early sepsis, and save their lives.”

 

Read the original Stat News article here.

 

Metro News: This 12-year-old’s death has saved almost 5,000 New Yorkers

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By Kimberly M. Aquilina
Published by Metro News, April 17, 2017

Rory Staunton would be in college this year. Instead, his family counts the years without him.

A foundation set up by an Irish family has saved thousands of American lives.

Rory Staunton, 12, cut his arm while diving for a basketball at his private school in New York on March 28, 2012. He died four days later from septic shock.

Sepsis, sometimes referred to as “blood poisoning,” is the result of a massive immune response to a bacterial infection. Sepsis can lead to organ failure, tissue damage and death.

Sepsis kills 258,000 Americans each year, according to the Sepsis Alliance.

After his death, Rory’s parents Orlaith and Ciaran, originally from County Louth, Ireland, established the Rory Staunton Foundation to raise awareness of the dangers of sepsis.

On Jan. 29, 2013, Gov. Andrew Cuomo announced all New York state hospitals would adopt Rory’s Regulations, evidence-based protocols for the early diagnosis and treatment of sepsis.

According to a recent New York State report, “Sepsis Care Improvement Initiative,” patients are being identified and treated earlier — a measure that is saving lives.

“Despite the early nature of this initiative we can demonstrate encouraging improvements,” report authors wrote.

Rory’s Regulations took effect in 2014. Mortality rates from sepsis in New York from the beginning of 2011 through the end of 2015 indicated that 4,727 fewer people died from it, according to the new report.

“We have met the people that have been saved by these protocols,” Ciaran Staunton, Rory’s father, told the Independent.

“We are happy that their parents are not joining us in this miserable life. We want that fighting chance extended to every family in America.”

Ciaran told the Independent that he hopes not for a cure, but for awareness and for all states to pass regulations.

“When our son died, there was no awareness, no sepsis protocols, nothing in the A-Z book on sepsis,” he said. “Now we’ve shown here’s what we can do in New York — we want the U.S. government to have the same level of anxiety and awareness of sepsis as they do Ebola.”

While playing in school on March 28, 2012, Rory scraped his arm in gym class and was patched up by a teacher.

Later, at home, his mother heard him vomiting.

“There wasn’t a huge amount of vomit, but he kept saying, ‘My leg, my leg, Mom,’” Rory’s mom, Orlaith Staunton, told The New York Times. In the morning, Rory’s temperature reached 104.

His pediatrician, Dr. Susan Levitzky, saw him that evening, but dismissed the leg pain saying it was probably due to the fall in class.

“We showed her the cut on his elbow, and I saw her follow up his arm from the cut,” Rory’s mom said. “She said, ‘The cut’s not an issue.’ She focused on his stomach. We said, ‘Although you see him throwing up, that’s not what he’s really complaining about.’ Rory and I both said to her that it’s the pain in his leg that’s really bothering him.”

Rory’s culture for strep came back negative, but his skin was mottled, another “worrisome observation,” an infectious disease specialist not involved in Rory’s care told The New York Times.

Levitzky sent Rory to the emergency room at NYU Langone Medical Center. He was treated for dehydration and sent home, the Independent reported.

Three hours later, the hospital’s laboratory found that Rory’s cell count was elevated, due to his body fighting a bacterial infection, but his parents were left in the dark.

“Nobody said anything that night,” Rory’s mom told The New York Times. “None of you followed up the next day on that kid, and he’s at home, dying on the couch?”

NYU Langone declined comment when contacted by The New York Times.

“Our deepest sympathies go out to the family at this difficult time,” said Lisa Greiner, a hospital spokeswoman.

Read original MetroNews article here.

Times Telegram: New Care Standards Lower Sepsis Death Rate

By
Published by Times Telegram, April 10, 2017.

New York has reduced the number of residents dying of sepsis since new regulations kicked in in 2014, state data shows.

Rory’s Regulations, named after Rory Staunton, 12, of Queens, who died of sepsis after a 2012 fall in the school gym, require hospitals to develop and implement protocols to diagnose and treat sepsis early, the first such requirement in the nation.

The protocols are needed, said Dr. Maria Gesualdo, president of Slocum-Dickson Medical Group and a pulmonary critical care specialist who’s heading up the sepsis initiative at the Mohawk Valley Health System.

“When somebody comes through the (emergency department), there’s a stroke alert,” she said. “We have protocols for myocardial infarction (heart attacks) … but we never had anything for sepsis.”

Sepsis, a dangerous reaction to infection, can progress rapidly, leading to the shutdown of the body’s organs and systems, making early intervention critical. It strikes 750,000 Americans each year, killing 200,000. It is the No. 1 cause of death in the hospital and the 11th leading cause of death overall.

In New York, mortality rates for sepsis among adults fell from 30.2 percent to 25.4 percent from mid-2014 through the end of September in 2016, according to the New York State Department of Health study. And the number of patients diagnosed with sepsis rose 20 percent, meaning hospitals got better at identifying patients, according to the study.

Much of the effort centers around screening all patients with infections to see if they may have or be at risk for sepsis, and the use of two protocol “bundles” for patients with sepsis. A bundle is a group of tests and treatments that all patients matching certain criteria should receive.

The three-hour bundle — care to be delivered within three hours — is to resuscitate patients who are severely septic or in septic shock, Gesualdo said. A six-hour bundle is for patients admitted with sepsis.

It’s not that doctors didn’t already know what to do, but they tended to “piecemeal” their treatments.

“Having it all in one order set, we capture everything,” she said. “We don’t miss any of the important elements.”

At Bassett Medical Center, Rory’s Regulations spurred specific initiatives such as a sepsis work group, an alert system for possible symptoms built into the electronic medical record, a rapid response team for a “coordinated and choreographed response,” and provider and nurse education, including the production of a new training video, said Chief of Medicine Dr. Charles Hyman.

“As a result of the above initiatives, Bassett Medical Center has made considerable progress over the past couple years,” he said. “Our 2016 compliance rate is above that of the (New York state) mean for sepsis protocol.”

That means more patients are receiving the prescribed care — such as a systemic antibiotic within one hour of diagnosis — quickly and fully. And the hospital’s sepsis mortality rate is falling below the state average, Hyman said.

The sepsis initiative has been important to spread awareness of a deadly issue and things are definitely improving, Gesualdo said. But perfect compliance doesn’t happen overnight. “It’s really a big initiative. We still have to iron out some wrinkles,” she said.

“It’s everybody’s responsibility,” she added. “We all have to work as a team. We need that nudging till it becomes knee-jerk response.”

Follow @OD_Roth on Twitter or call her at 315-792-5166.

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CBS Philly: Pennsylvania Considering Statewide Protocols For Hospitals To Treat Sepsis

Conall Harvey

Stephanie Stahl from CBS News in PA interviews young Conall Harvey who survived sepsis when he was four years old in March 2015. Since then his parents John and Christin Harvey and the parents of Emily Aiello, Chris and Krista Aiello, have joined with the National Family Council on Sepsis and the Rory Staunton Foundation to successfully lobby for mandatory sepsis protocols in the State of Pennsylvania. Emily Aiello died tragically at fourteen years of age from undiagnosed sepsis.

Society of Critical Care Medicine: A Critical New Study Shows Sepsis Care Saves Lives and Money!

Rory Staunton Foundation, critical, critical care, society of critical care medicine, sepsis, sepsis protocol

A new study just published in the Journal of the Society of Critical Care Medicine shows that patients who receive aggressive care for sepsis within the first three hours of hospitalization have a much stronger survival rate. This higher survival rate is accompanied by lower costs to the hospital and to the U.S. healthcare system in general.

This is a crucial development because it shows a direct link between mortality and costs. This link to survival and reduced costs provides a very strong, convincing argument for every state to adopt sepsis protocols. The National Family Council on Sepsis and the Rory Staunton Foundation advocate for every State to have mandatory sepsis protocols. We call for all State Health Secretaries and Health Commissioners to implement mandatory sepsis protocols immediately and save lives! This report has confirmed what the Rory Staunton Foundation has been saying all along that not alone do sepsis protocols save lives but they also save tax payers a lot of money.

Dr. Martin E. Doerfler, MD, a member of the Medical Advisory Board of the Rory Staunton Foundation is a member of the team of doctors involved in the study.

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