Paramedics and A&E doctors often miss signs of sepsis and two of four methods used by healthcare professionals to screen for the deadly disease don’t work, a new study suggests.
Sepsis, often described as blood poisoning, is estimated to kill around 48,000 people a year in the UK.
Doctors, NHS bosses and health charities have worried for years that too many cases go undiagnosed, leaving people seriously injured or dead because sepsis is so difficult to detect.
Unless a patient is diagnosed quickly, their body’s immune system goes into overdrive in response to an infection and then attacks vital tissues and organs. If left untreated, sepsis can cause shock, organ failure and death.
Research from Germany claims to have discovered significant flaws in two of the four screening tools used by health workers around the world to identify cases of the potentially deadly disease.
The four systems are NEWS2 (National Early Warning Score), qSOFA (quick Sequential Organ Failure Assessment), MEWS (Modified Early Warning Score) and SIRS (Systemic Inflammatory Response Syndrome).
Researchers analyzed the care records of 221,429 patients in Germany who were treated by emergency health workers outside the hospital setting in 2016.
“Only one of four screening tools offered a reasonably accurate prediction rate for sepsis – NEWS2. It was able to correctly predict 72.2% of all sepsis cases and correctly identify 81.4% of negative, non-septic cases,” they concluded.
Silke Piedmont, a scientist from the Department of Emergency Medicine at the Universitätsmedizin Berlin, said: “We found that paramedics never documented suspected sepsis and that emergency department doctors did. rarely done, documenting only suspicion in 0.1% of cases. »
Health care workers are much more likely to correctly identify the signs of a heart attack or stroke, meaning these patients have a greater chance of survival. Problems with sepsis detection meant that 31.4% of sepsis patients in the study died within 30 days, compared to 13.4% of those who had a heart attack and 11.8% of sepsis victims. “a stroke,” said co-author Dr. Wolfgang Bauer.
The findings, which have not been peer-reviewed and are described as “observational”, are being presented this week at the European Congress of Emergency Medicine in Barcelona.
NHS England highlighted that it is already rolling out NEWS2, which has been shown to be the best system.
An NHS spokesperson said: “This study shows that the NHS is in fact using the best screening tool available to detect sepsis – NEWS2 – and as professional advice for doctors in England makes clear, it is essential that the any patient’s wish to seek a second opinion is respected. .”
Steve Barclay, the Health Secretary, announced plans last week to introduce ‘Martha’s Rule’ into the NHS in England. It will give patients and their families the right to seek a second medical opinion if they are unhappy with their diagnosis or treatment.
Martha, 13, died in 2021 after developing sepsis while in the care of the NHS trust at King’s College Hospital, south London.
Dr Adrian Boyle, president of the Royal College of Emergency Medicine, which represents A&E doctors, said: “Sepsis continues to be extremely difficult to diagnose in the early stages. The problem is that the first symptoms often resemble less serious conditions.
“To reduce the risk of missing this potentially devastating diagnosis, we recommend early assessment by a trained clinician and routine use of early warning scores such as NEWS2.”
We have contacted the College of Paramedics for their response.
theguardian