GPs should treat suspected sepsis as urgently as heart attack, says NICE

GPs should afford sepsis the same urgency as a suspected heart attack and refer patients at severe risk to hospital by ambulance immediately, the latest NICE guidance recommends.

Ambulance: Sepsis cases should be treated as urgently as possible heart attack (Photo: iStock)
Ambulance: Sepsis cases should be treated as urgently as possible heart attack (Photo: iStock)

Patients who show signs of sepsis should be treated with the same urgency as those with chest pains that could signify a heart attack, NICE has warned in first guidance on the illness.

It advises GPs to think ‘could this be sepsis?’ earlier on when assessing someone with signs or symptoms that could indicate possible infection.

People at high risk of severe illness from sepsis should be referred via ambulance to hospital, the guideline states. Patients should also be referred if they exhibit moderate risk criteria and are under 17 and their immunity is impaired due to drugs or illness.

The guidance features tables of symptoms allowing clinicians to quickly ascertain the significance and severity of patient symptoms for different age groups.

Sepsis treatment

It adds that hospitals should be pre-alerted about a person with suspected sepsis following their immediate transfer.

It also recommends that GPs should have mechanisms in place to administer antibiotics to patients with high risk criteria if their transfer time to hospital will exceed one hour.

Sepsis cases number up to 150,000 a year, contributing to 44,000 deaths, according to the UK Sepsis Trust. A report published last year found there were delays in identifying sepsis in over a third of cases (36%).

RCGP chairwoman Dr Maureen Baker said: ‘The diagnosis of sepsis is a huge worry for GPs as initial symptoms can be similar to common viral illnesses so we welcome any guidance or support to help us identify it as early as possible.

‘Sepsis is one of the College’s Spotlight projects until April 2017, and as part of this programme we will be working with NHS England and Health Education England to help improve the outcomes from sepsis, particularly in collaboration with colleagues across the NHS to reduce deaths from sepsis each year across the UK.’

GP referral

Professor Saul Faust, who chaired the guideline development group, said: ‘We want clinicians to start asking "could this be sepsis?" much earlier on so they can rule it out or get people the treatment they need.

‘The thinking should be similar to considering that chest pain could be heart related. Just like most people with chest pain are not having a heart attack, the majority of people with an infection will not have sepsis. But if it isn’t considered then the diagnosis can be missed.’

Professor Mark Baker, director of the NICE centre for guidelines, said: ‘If there is any delay in spotting the signs we will fail patients by leaving them with debilitating problems or in the worst cases people will die.

‘This guideline will be the first to provide advice based on the best available evidence on how to quickly identify and treat people with sepsis.’

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