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INFECTION CONTROL
Sepsis in the spotlight A national effort to support clinicians, consumers and health service organisations Dr Carolyn Hullick*, Emergency Physician and Clinical Director, and Chris Boyd-Skinner*, Sepsis Program Manager, the Australian Commission on Safety and Quality in Health Care
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ach year, sepsis — the life-threatening complication of infection which can lead to multiple organ failure — kills more Australians than breast or prostate cancer. National data indicate that sepsis cases are increasing in Australia, while a recent Global Burden of Disease report suggests that the international incidence of sepsis is vastly underestimated. Yet recognising sepsis as a time-critical medical emergency can prevent the worst health complications. The Australian Commission on Safety and Quality in Health Care (the Commission), is joining the efforts of the states and territories to help improve outcomes for Australians with sepsis and raise awareness of this under-recognised condition. Emergency physicians often find themselves in the unenviable position of witnessing how rapidly situations can escalate in patients with sepsis. Non-specific symptoms can make sepsis difficult to detect. In addition, when patients present to the emergency department, they may already be seriously unwell, leaving only a narrow window of opportunity to start life-saving treatment and to reduce ongoing morbidity. 28
HOSPITAL + HEALTHCARE
The impact of sepsis on Australians is profound, affecting many age cohorts and high-risk populations. The recent 2020 Global Burden of Disease study reported an estimated 55,000 cases of sepsis in Australia annually, with approximately 8700 people succumbing to the condition. Sepsis is also a major public health concern, placing substantial economic burden and strain on the Australian healthcare system. A new report commissioned by The George Institute for Global Health estimates the total annual cost of sepsis in Australia is $4.8 billion, with direct hospital costs accounting for $700m a year. Sepsis is defined as a life-threatening condition that arises when the body’s response to an infection damages its own tissues and organs. Patients who survive sepsis experience varying degrees of impairment following their hospital stay. Ongoing health and cognitive issues may persist following the acute illness, and in more severe cases, significant physical disability may occur, including limb amputation. Post-sepsis syndrome is unfortunately SPRING 2021
not well understood or recognised by clinicians globally. However, the lingering health complications experienced by sepsis survivors are very real and well documented. State and territory health departments and health service organisations alike have made commendable progress to facilitate improvements in detection, recognition and management of sepsis. Notably, New South Wales, Victoria and Queensland Health Departments have well-established and integrated programs of work in the context of sepsis. Trigger tools and sepsis pathways help support clinicians to identify the signs and symptoms of sepsis and manage care. However, to this point, there has been no national guidance for sepsis management.
A national effort against sepsis The Commission, in partnership with the George Institute for Global Health, is leading the National Sepsis Program. The Program is being delivered on behalf of the Australian Government Department of Health following a funding announcement in 2019 by the Hon. Greg Hunt MP, Minister for Health and Aged Care.
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