Implementing standardized Sepsis Alert protocol for improved diagnosis: addressing policy flaws

Responsible for 20% of global deaths, sepsis is a public health crisis accredited to preventable policy flaws. Despite its fatal consequences, there is inadequate initiative taken to improve the use of systematic protocol in diagnosing sepsis. Studies by Jones et al. show that while technologies to better diagnose sepsis exist, Emergency Medical Services (EMS) personnel may forget or neglect their use to prioritize other medical emergencies, commonly manifesting as the eventual cause of death among EMS patients. Our research evaluates the effectiveness of standardizing the use of the Sepsis Alert protocol in improving diagnosis rates. Developed by Guerra et al., the Sepsis Alert protocol uses existing sepsis screening tools in conjunction with capnography testing to simplify EMS sepsis identification, increasing detection by six-fold and diminishing mortality rates from 26.7% to 13.6%. However, there is currently no institution responsible for the centralized certification of paramedics; although the National Occupational Competency Profile (NOCP) evaluates the skills and competencies of paramedics for baseline proficiencies, it is ultimately within the power of each subnational unit to execute its own emergency medical practices. Further, there is no regulatory body to standardize the practice and protocol of regional EMS centres, leaving each to independently develop sepsis protocols that vary significantly in effectiveness. Most EMS crew are consequently untrained to diagnose sepsis among EMS patients, with Lane et. al showing a successful diagnosis rate of only 8-10%. Thus, implementing Sepsis Alert within Canadian healthcare systems would hold immense improvement in diagnosis and preventing septic death. By: Donny Li, Jeffrey Sun, & Lucy Zhao, Level I Bachelor of Health Sciences Students at McMaster University