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Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock.
Emerg Med Australas. 2020 Jun 29 [Online ahead of print]EM

Abstract

OBJECTIVE

Early recognition and treatment for sepsis is critical in improving patient outcomes. The present study sought to examine whether triage location was associated with time to appropriate antibiotics in a cohort of ED patients with septic shock.

METHODS

Septic shock patients were identified from a database of ED patients admitted with infection. Demographic, clinical and outcome data were reported by triage location. Time to event analyses sought to identify the association between triage location and time to appropriate antibiotic. Secondary outcome variables included ED and hospital length of stay (LOS), 30-day mortality, and ICU admission.

RESULTS

Time to appropriate antibiotic administration was longer for those patients triaged to lower acuity (242 min) compared to higher acuity (98 min, P < 0.01) locations. After adjustment for severity of illness, hospital LOS, ED LOS and 30-day mortality were similar regardless of the triaged location. Admission to ICU was lower for patients triaged to lower (7.3%) compared to higher (47.3%) acuity treatment locations.

CONCLUSIONS

We identified a sub-group of septic shock patients triaged to a lower acuity treatment location who received significant delays to antibiotics. This research area deserves closer examination to potentially recognise septic shock earlier in the continuum.

Authors+Show Affiliations

Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32602254

Citation

Ryan, Kimberley, et al. "Examining the Association Between Triage Streamed Treatment Location and Time to Appropriate Antibiotics in Emergency Department Patients With Septic Shock." Emergency Medicine Australasia : EMA, 2020.
Ryan K, Greenslade J, Williams J. Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock. Emerg Med Australas. 2020.
Ryan, K., Greenslade, J., & Williams, J. (2020). Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock. Emergency Medicine Australasia : EMA. https://doi.org/10.1111/1742-6723.13552
Ryan K, Greenslade J, Williams J. Examining the Association Between Triage Streamed Treatment Location and Time to Appropriate Antibiotics in Emergency Department Patients With Septic Shock. Emerg Med Australas. 2020 Jun 29; PubMed PMID: 32602254.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock. AU - Ryan,Kimberley, AU - Greenslade,Jaimi, AU - Williams,Julian, Y1 - 2020/06/29/ PY - 2019/12/22/received PY - 2020/05/05/revised PY - 2020/05/08/accepted PY - 2020/7/1/entrez KW - emergency service KW - hospital KW - septic KW - shock KW - triage JF - Emergency medicine Australasia : EMA JO - Emerg Med Australas N2 - OBJECTIVE: Early recognition and treatment for sepsis is critical in improving patient outcomes. The present study sought to examine whether triage location was associated with time to appropriate antibiotics in a cohort of ED patients with septic shock. METHODS: Septic shock patients were identified from a database of ED patients admitted with infection. Demographic, clinical and outcome data were reported by triage location. Time to event analyses sought to identify the association between triage location and time to appropriate antibiotic. Secondary outcome variables included ED and hospital length of stay (LOS), 30-day mortality, and ICU admission. RESULTS: Time to appropriate antibiotic administration was longer for those patients triaged to lower acuity (242 min) compared to higher acuity (98 min, P < 0.01) locations. After adjustment for severity of illness, hospital LOS, ED LOS and 30-day mortality were similar regardless of the triaged location. Admission to ICU was lower for patients triaged to lower (7.3%) compared to higher (47.3%) acuity treatment locations. CONCLUSIONS: We identified a sub-group of septic shock patients triaged to a lower acuity treatment location who received significant delays to antibiotics. This research area deserves closer examination to potentially recognise septic shock earlier in the continuum. SN - 1742-6723 UR - https://www.unboundmedicine.com/medline/citation/32602254/Examining_the_association_between_triage_streamed_treatment_location_and_time_to_appropriate_antibiotics_in_emergency_department_patients_with_septic_shock L2 - https://doi.org/10.1111/1742-6723.13552 DB - PRIME DP - Unbound Medicine ER -
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