Article : Staff Education Improves Compliance...

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.


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