Staff Education Improves Compliance with Pediatric Septic Shock Guidelines

Children with septic shock were identified and treated earlier after a staff education program was implemented at a single pediatric emergency department.


In a study at a tertiary pediatric emergency department, researchers compared identification of patients with septic shock at triage, compliance with guidelines, and clinical outcomes before and after institution of a staff education program on the current national guidelines for pediatric septic shock. Ninety-eight patients with septic shock presented during the 2 years before implementation, 70 presented during the year of implementation, and 177 presented during the year after implementation (overall age range, 1 day to 18 years; median age, 5.7 years).

Compared with the preimplementation period, in the postimplementation period, compliance improved significantly in three key care elements: administration of 20 mL/kg of normal saline in the first hour (43% vs. 79%), measurement of lactate (10% vs. 81%), and administration of antibiotics within 3 hours (53% vs. 81%). The mortality rate did not differ significantly between children who did and those who did not receive these three care elements (3.5% and 8.4%). Median hospital length of stay declined significantly from 181 hours in the preimplementation period to 140 hours in the postimplementation period.


Citation(s):

Larsen GY et al. An emergency department septic shock protocol and care guideline for children initiated at triage. Pediatrics 2011 Jun; 127:e1585.