Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock

• Published in: Emergency medicine Australasia Vol. 32; no. 6; pp. 1008 - 1014
• Main Authors: Ryan, Kimberley, Greenslade, Jaimi, Williams, Julian
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.12.2020
• Subjects: emergency service; hospital; septic; shock; triage; septic; hospital; triage; emergency service; shock
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.13552

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.