Short Attention Span Summary
Sepsis pit crew
For each hour delay in antibiotic administration in patients with sepsis, mortality rose 0.3%; 1.8% per hour for septic shock. This was a retrospective random sample of 35,000 sepsis patients from 2010-2013, including 21 EDs from a large northern California database. An idea that has been helpful where I work is to systematize "sepsis alerts" similar to STEMI alerts.
Once sepsis is detected, start broad spectrum antibiotics as soon as possible. Delays were associated with mortality: 1 hour = ~1%. There is some controversy surrounding timing of antibiotics in sepsis, but this is another bit of evidence that indicates sooner is better.
The Timing of Early Antibiotics and Hospital Mortality in Sepsis.
Am J Respir Crit Care Med. 2017 Mar 27. doi: 10.1164/rccm.201609-1848OC. [Epub ahead of print]