Over the past two years, simultaneous with the departure of Dr. Dellinger from the SSC, the collaborative culture changed. Although the majority of sepsis patients are identified and initially treated outside of the ICU, clinical perspectives from service lines such as emergency medicine, hospitalists, nurses, or infectious disease were not considered when developing definitions. This decision resulted in reduced uptake. Additionally, a few months after completing a yearlong process of guideline development, SSC executive committee members, independent of the multispecialty guideline committee, published the Hour-1 Bundle. This bundle, directed toward ED practice without representation from the emergency medicine community and without review by the multispecialty SSC Guidelines Committee, is misguided and should serve as an alarming precedent for all professional organizations participating in the SSC. When a letter to the editor was written in response to the Hour-1 Bundle, it was not published due to a Society of Critical Care Medicine (SCCM) policy of having concerns directed to the guideline committee chair.
Explore This IssueACEP Now: Vol 37 – No 11 – November 2018
This is a challenging time. ACEP is working diligently with SCCM and the SSC. Although individual service lines can incrementally impact mortality, no service line can truly optimize sepsis survival alone. From 2003 to 2015, patient survival has improved due in part to this global cooperative work. I hope we can get back to the real mission, caring for the patients we are called upon to serve. Our patients need us all to be more than individual service lines; they need us to provide a service.
Part 2 of this history will appear in the December issue.
Dr. Osborn is professor of surgery and emergency medicine at Barnes-Jewish Hospital/Washington University in St. Louis, Missouri.
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