AUDIT OF SEPSIS IN AN INDIAN TERTIARY CARE CENTRE

Our audit titled audit of sepsis in an Indian tertiary care Center was conducted to assess the percentage of patients in whom the SEPSIS 1 HOUR BUNDLE was followed in our emergency and the steps taken to improve it in our hospital. The study was conducted in a tertiary care center Peerless Hospital and B.K.Roy research center, Kolkata, India. The sample size for the audit is 132. The study was conducted over a period of 1year . As per the Surviving Sepsis guidelines 2017, it was said that the initial resuscitation for sepsis should begin within 1 hour of recognition of sepsis, to decrease the mortality. The components of surviving sepsis bundle is IV crystalloid infusion, blood cultures, IV antibiotics, lactate measurement and early initiation of vasopressors to maintain MAP >65mmHg. From the above study period of 1 year, 67% of the patients were above 60 years and 33% of the patients were below 60 years of age. With this guideline reference, in our audit, we found that 66% of patients received IV crystalloids within 1 hour, in 23% of patients lactate was measured within 1 hour of recognition, blood cultures were taken within 1 hour in 49% of patients, 46% of patients received antibiotics within 1 hour. The lack of awareness regarding the importance of lactate clearance has led to delay in lactate measurement and only 23% of patients had lactate measured within 1 hour. All Emergency departments should have a sepsis lead and a sepsis protocol. Education and training about the importance of 1 hour bundle should be done for wider team for early recognition and instigation of optimal care.