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Millenium - Journal of Education, Technologies, and Health
Print version ISSN 0873-3015On-line version ISSN 1647-662X
Abstract
FERREIRA, Carolina; DIAS, António Madureira and SANTOS, Eduardo. Performance protocols in the approach to the patient with sepsis in the emergency department: a systematic review with meta-analysis. Mill [online]. 2021, n.esp9, pp.91-99. Epub Dec 07, 2021. ISSN 0873-3015. https://doi.org/10.29352/mill029e.25020.
Introduction:
Sepsis has become a major health problem affecting millions of people annually, and its early identification and appropriate treatment in the first hours is emergent. The implementation of protocols can improve outcomes, however this is still a subject under debate.
Objetive:
To describe the impact of the use of protocols in emergency departments on the approach to patients with sepsis in order to reduce time to the first antibiotic and mortality.
Methods:
A systematic review with meta-analysis was conducted following the methodology proposed by the Joanna Briggs Institute. Two independent reviewers performed the critical appraisal, extraction and synthesis of data.
Results:
Seven studies were included. The results of the meta-analysis showed no differences in the mortality rate (all hospital time) (RR=0.84, 95%CI=0.63-1.14, p=0.27). However, for 30-day mortality there are significant differences favouring the group that used protocols in the approach to the sepsis patient (RR=0.80, 95%CI=0.68-0.95, p=0.01) and a reduction of time to antibiotics (MD=-41.83, 95%CI=-77.89- -5.77, p=0.02).
Conclusion:
Emergency department protocols reduce mortality and the time until the first antibiotic is taken. Therefore, their implementation is essential to improve health outcomes.
Keywords : sepsis; shock, septic; antibiotic prophylaxis; mortality; clinical protocols.