By Stacey Kusterbeck
Recognizing sepsis in children “continues to be a struggle for many frontline organizations,” says Emily Sterrett, MD, MS, associate professor of pediatrics at Duke University.
Sterrett and colleagues analyzed pediatric sepsis patients who presented to an ED from 2015 to 2021.1 During 2018, after a pediatric provider-in-triage was added, the average time from ED arrival to blood culture orders declined by 1.1 hours. The time from arrival in the ED to receiving antibiotics declined by 1.5 hours, and the average time it took to examinate was cut by 14 minutes.
“The nuance and advanced practice required to distinguish between a childhood febrile illness and sepsis is a significant vulnerability for most emergency departments,” Sterrett says.
Using the provider in triage model can improve recognition and appropriate triage of children with high-risk, time-sensitive morbidities, Sterrett and colleagues reported. “Unfortunately, physician-level triage is a very costly intervention,” Sterrett laments.
Therefore, this provider in triage model is not feasible for many departments.
“More research is needed to identify which key elements of physician-based triage can be reliably replicated using cost-effective resources in order to balance these liabilities and risks,” Sterrett offers.
REFERENCE
1. Moorthy GS, Pung JS, Subramanian N, et al. Causal association of physician-in-triage with improved pediatric sepsis care: A single-center, emergency department experience. Pediatr Qual Saf 2023;8:e651.
However, more research is needed to identify which key elements of this process can be reliably replicated using cost-effective resources to balance liabilities and risks.
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