Sepsis/ RRAILS / AKI
Sespis, RRAILS and AKI
It is a complex condition to manage as there isn’t a common presentation and in 60% of cases an infective organism is never identified. Sepsis management is a heavy resource user as 15% of ITU patients are septic but they utilise 30% of our resources. In the UK, sepsis costs us almost £300 million a year but the costs to individuals and their families is intangible and has a far greater impact.
Early detection with prompt and appropriate treatment is of paramount importance to improve survival rates. In Wales, as part of the 1000 lives campaign, we have put in place measures that have resulted in an award winning 20% reduction in mortality – 700 additional survivors from sepsis in 2012/13.
The measures we have used successfully involved educating and engaging the members of the multidisciplinary clinical team in using the “sepsis bundle”. The sepsis bundle is a package of tests and interventions which when done together in a timely fashion have been shown to improve outcomes. Our package, sepsis 6, is described on the sepsis trust website and is an easy way to remember and implement these key elements. The overall success of the sepsis bundle is still critically dependant on multidisciplinary team input.
As we do more research and find out more about the causes and development of the septic process, we are getting better in identifying and managing it with improved mortality figures but we must remain ever vigilant to maintain our high standards.
Acute Deterioration (RRAILS)
The Rapid Response to Acute Illness Learning Set is a national programme focussed on reducing harm and variation amongst patients; individuals either at risk or suffering from acute deterioration.
Sepsis and AKI
This is a common feature of Sepsis as well as a cause of acute deterioration in its own right and therefore AKI constitutes a large focus of our Acute Deterioration work programme. Wales has a system of comprehensive AKI e-alerts