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New sepsis protocols could lead to medical complications

New guidelines that set a one-hour treatment window for sepsis patients in Pittsburgh and around the world could cause adverse outcomes, according to a recent editorial published in the Annals of Emergency Medicine. The authors of the editorial recommend reverting to previous sepsis guidelines, which called for less restrictive treatment times.

The Surviving Sepsis Campaign, or SSC, care bundle is supposed to help emergency department staff quickly identify and treat patients with sepsis. Under the guidelines, patients are required to receive a series of treatments within one hour of getting a sepsis diagnosis. The protocol involves measuring a patient's lactate level, obtaining blood cultures, administering broad-spectrum antibiotics, rapidly administering drugs to regulate hypotension and lactate levels and applying vasopressors to maintain arterial pressure. The one-hour window for completing these actions begins from the moment a patient arrives in triage.

However, the editorial argues that there isn't enough evidence to support this rapid timeline and the protocol could lead to misdiagnoses, overly aggressive treatments and poor outcomes. It further argues that the protocol increases emergency department costs and presents logistical challenges to staff, which could delay care and increase the risk of medical complications. The authors conclude that a better approach would be to focus on the identification of the subgroup of patients who need immediate sepsis treatment and treating all other patients under the previous three-hour and six-hour protocols.

Sepsis can cause long-term health problems or even death. When patients suffer sepsis due to doctor or hospital negligence, they may have grounds to file a medical malpractice lawsuit seeking compensation for damages. An attorney familiar with malpractice claims might evaluate a patient's case and determine if the standard of care was provided. If the doctor or hospital is found at fault, the patient may be owed a settlement for medical expenses, pain and suffering, lost wages and more.

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