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Sepsis Detection in Emergency Care: Evaluating Screening Tools and Advancements in Long-COVID Treatment

Four internationally recommended sepsis detection tools used by emergency medical services (EMS) were investigated, revealing a disparity in their accuracy rates. This research, presented at the European Emergency Medicine Congress in Spain, was led by a team from Universitätsmedizin Berlin who linked the health insurance data of 221,429 EMS patients in Germany with data from paramedics and emergency department doctors between 2016 and 2017. Sepsis, a life-threatening reaction to infection that can result in organ damage or fatality, must be rapidly identified and treated for best survival rates.

The Surviving Sepsis Campaign Guidelines 2021 of the Society of Critical Care Medicine prescribes four sepsis screening tools. The study showed that the National Early Warning Score (NEWS-2) was the most accurate, predicting 72.2% of sepsis cases, followed by the Modified Early Warning Score (MEWS; 46.8%), the Systemic Inflammatory Response Syndrome (SIRS; 30.4%), and the quick Sequential Organ Failure Assessment (qSOFA; 24.0%). These are termed sensitivity scores. When considering specificity scores, or identification of non-septic cases, the qSOFA was best (96.6%), followed by SIRS (93.8%), MEWS (88.4%), and NEWS-2 (81.4%).

Lead researcher Silke Piedmont stressed the significance of a positive NEWS-2 outcome, suggesting that it warrants a potential sepsis flag. Piedmont noted that while a positive qSOFA result hints at sepsis likelihood, a negative result does not conclusively eliminate the possibility. It was found that sepsis suspicions were rarely documented by EMS – paramedics never once indicated such a suspicion, while emergency services doctors did so in only 0.1% of cases.

Interestingly, sepsis was predicted in 24.3% of all EMS cases by at least one screening tool, yet merely 0.9% of cases were flagged by all four tools. Compared to improvements in identifying and treating heart attacks and stroke, sepsis standards appear to be neglected, leading to more patient deaths due to sepsis despite its similar incidence.

In another development, the US Department of Health and Human Services (HHS), through its Agency for Healthcare Research and Quality (AHRQ), announced $9 million in grants to support long-COVID clinics, aiding patients, especially those in underserved groups and areas, to combat the enduring ramifications of COVID-19. With grants aiming to increase access to care through virtual and in-person visits, adding dedicated care coordination and behavioral health staff, this is part of an ongoing effort to expedite long-COVID research and aid those battling the condition.

Source: https://www.cidrap.umn.edu/sepsis/only-fourth-recommended-sepsis-screening-tools-can-reasonably-predict-sepsis-researchers-say

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