News: Surviving Sepsis guidelines updated

The Surviving Sepsis Campaign released updated guidelines, advising that physicians and healthcare teams to collect blood cultures and lactate, begin 30 ml/kg fluid resuscitation for hypotension or lactatemia, and start vasopressors within one hour from the time the patient arrives at the hospital.

In previous versions of the Surviving Sepsis Campaign guidelines, the same interventions were advised within three and six-hour timeframes.

According to PulmCCM, this new “1-hour bundle” has spurred some backlash from the medical community. Because there isn’t one set of criteria used for sepsis diagnoses, the short timeframe could lead to over-treatment. The guidelines suggest that the sepsis clock starts when a patient is first seen in the ED, leaving little time for a full work-up or medical decision-making.

For CDI professionals, this short window of time may also bring up some new documentation concerns, according to Laurie Prescott, RN, MSN, CCDS, CDIP, CRC, CDI education director at HCPro in Middleton, Massachusetts.

“Such guidelines require critical thinking,” she says. “If the treatment may lead to more harm than good, it should not be applied. Providers need to apply the criteria and treatment thoughtfully, not just leap to treat because the guideline states one should. Documentation of their medical decision-making—why they chose not to follow protocol—is very important.”

In light of the concerns regarding the new guidelines, many physicians are speaking up against them. More than 20 academic physicians and thought leaders have co-signed a statement strongly criticizing the Campaign guidelines, PulmCCM reported.

Additionally, an online petition has been created requesting that the new guidelines not be adopted for “any hospital-specific guidelines/protocols, government interventions, or mandated care.” As of this article’s publication, the petition garnered nearly 1,000 signatures.

Editor’s note: To read the new guidelines from the Surviving Sepsis Campaign, click here. To read about the pushback on PulmCCM, click here.