The diagnosis of sepsis using POCT in the Emergency Department – Medical and legal implications

Abstract

Sepsis, severe sepsis and septic shock are some of the most serious affections which threaten the lives of the patients who come to the Emergency Department and which require fast treatment because the more severe the sepsis was, the higher the mortality, up to 50% higher in severe sepsis. That is why, at present, the 2013 Guides of Surviving Sepsis Campaign recommend that the potential source of infection should be confirmed as soon as possible, in the first 6 hours since the patient arrived in the Emergency Unit if possible, moreover the large spectrum antibiotics therapy must be administered in one hour after the severe sepsis or the septic shock were identified. That is why the identification of these patients at risk is very important and this identification can only be made using POCT type devices. This type of devices has the capacity to make precise determinations, in a short time (15-17 minutes), using minimum quantities of integral blood, without using test tubes, sepsis biomarkers and other additional material. The possibility to fast diagnose sepsis, offers the doctors from the Emergency Department, the capacity to fast initiate an antibiotic treatment, to hospitalize the patient and at the same time, it gives them the certainty that they did not miss the sepsis diagnosis, thus avoiding the situation of malpractice. A preliminary study, regarding the sepsis biomarkers, which took place in the Emergency Unit of University Central Emergency Military Hospital, is also presented within this article.

Keywords

• sepsis
• POCT
• Emergency Department