SEP-1 is a Quality Measure issued by CMS, stipulating a protocol for the treatment of severe sepsis or septic shock patients.
Consistent with Surviving Sepsis Campaign guidelines, SEP-1 involves measurement of lactate, obtaining blood cultures, administering broad spectrum antibiotics, fluid resuscitation, vasopressor administration, reassessment of volume status and tissue perfusion, and repeat lactate measurement.
The first three interventions, noted above, should occur within 3 hours of presentation of severe sepsis, while the remaining interventions are expected to occur within 6 hours of presentation of septic shock.
How can Cheetah Medical help you comply with the SEP-1 bundle?
Cheetah is the only device with demonstrated outcome data that will allow your hospital to meet the reassessment of volume status and tissue perfusion of the 6-hour bundle… with a nurse-performed PLR!
The Passive Leg Raise (PLR) technique, when used in conjunction with Cheetah’s non-invasive hemodynamic monitoring technology, translocates 250-300 cc of blood from lower extremities into the heart, provides:
- Reversible challenge of the heart’s response to increased fluid load
- Real-time quantification of a patient’s fluid responsiveness
WHY PARTNER WITH CHEETAH MEDICAL?
- Non-Invasive: Cheetah Medical provides a dynamic assessment of fluid responsiveness, accurately, precisely and 100% non-invasively.
- Validated Technology: Cheetah has a large and growing body of clinical evidence, with technology validation in multiple clinical settings.
- Published Clinical Outcomes in Sepsis Patients: Recent research from the University of Kansas Medical Center has shown that effective fluid management can reduce hospital ICU stays by an average of 2.89 days, reduce the risk of mechanical ventilation and the initiation of acute dialysis,1 and show associated cost savings of over $14,000 per treated patient.
SEPSIS AND SEPTIC SHOCK
Sepsis is life-threatening organ dysfunction caused by the body’s aggressive response to severe, blood-borne infection, which can lead to tissue damage, organ failure, and death. Septic shock is a perfusion emergency associated with hypotension and hypoperfusion1,2.
Extensive literature demonstrates the importance of optimal management of IV fluid in septic shock. Clearly in the septic patient population, achieving the proper fluid balance between over and under resuscitation is crucial to avoiding increased morbidity, mortality and cost.[MW1]
SEPSIS STATISTICS AND TRENDS
- Every year, severe sepsis strikes more than 1.7 million Americans.3
- Severe Sepsis and Septic Shock Kills 1 in 3 affected patients.3 A cornerstone of treating patients with Septic Shock is IV Fluid therapy. However, volume overload in septic patients is associated with an increased risk of mortality. 4,5
- The Agency for Healthcare Research and Quality lists sepsis as the most expensive condition treated in U.S. hospitals, costing more than $24 billion in 2013. 6
- Sepsis is not only the most common cause of hospital readmission, but the mean length of stay is also longer than that of AMI, heart failure, COPD, and pneumonia. 7
- Based on the results of three major clinical studies (ProCESS, ARISE and ProMISE), leading organizations have updated their sepsis management guidelines:
- Surviving Sepsis Campaign8
- CMS / National Quality Forum9
- European Society of Intensive Care Medicine10
1. Al-Khafaji A, Pinsky M, et al. Multiple organ dysfunction in sepsis: Background, Pathophysiology, Epidemiology. http://emedicine.medscape.com/article/169640-overview#a4.
2. Martin G. Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Exp Rev Anti Infec 2012; 10: 701-706.
3. Rhee C et al. Incidence and trends of sepsis in us hospitals using clinical vs claims data, 2009-2014. JAMA 2017; 318:1241-1249.
4. Sirvent et al (2014). Fluid balance in sepsis and septic shock as a determining factor of mortality. American Journal of Emergency Medicine 2015; 33: 186–189.
5. Kelm et al (2015)-Fluid overload in patients with severe sepsis and septic shock treated with early goal directed therapyis associated with increased acute need for fluid-related medical interventions and hospital death. Shock 43: 68-73
6. Torio C et al. Agency for Healthcare Research and Quality. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013. HCUP Statistical Brief #204. May 2016. Agency for Healthcare Research and Quality, Rockville, MD
7. Mayr FB, et al . Proportion and cost of unplanned 30-day readmissions after sepsis compared with other medical conditions. JAMA 2017; 317: 530-531.
10. Cecconi M, Backer DD, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. 2014; 40(12)1795-815.