Awareness of the Surviving Sepsis Campaign amongst emergency medicine and surgical trainees

Introduction

Data presented at the 2006 Barcelona conference of the European Society of Intensive Care Medicine showed that, where implemented, the Surviving Sepsis Campaign guidelines have improved mortality from sepsis. However, because of overall poor adherence to the guidelines, the stated aim of the campaign to reduce mortality from severe sepsis by 25% is unlikely to be met. In the United Kingdom, patients with sepsis of surgical origin will typically be seen by emergency medicine (EM) before being admitted to a surgical ward and are unlikely to be initially managed by the ICU. Both the EM and surgical juniors should therefore be aware of the guidelines. The aim of this study was to determine the level of awareness of the SSC guidelines in surgical and EM trainees.

Methods

A questionnaire-based survey was undertaken of all EM and surgical trainees in the Eastern region of the United Kingdom. Participants were recruited by post, telephone, email and in person. The questionnaire assessed whether participants had experience in critical care, were aware of the campaign or its guidelines and assessed the level of familiarity of key concepts of the resuscitation bundle of the guidelines. In addition, participants were encouraged to comment on any aspect of sepsis management.

Results

Summarised in Table 1. There are 29 EM and 52 surgical trainees in the Eastern region; responses were obtained from 22 and 34, respectively. The responses to the key concepts of the resuscitation bundle varied greatly, even between different participants from the same speciality in the same institution, suggesting a lack of clear direction. Free text responses included 'the only people that know about guidelines for sepsis are the ICU physicians' and 'the only time I have heard of early goal directed therapy was on ER'.

Table 1 (abstract P71)

Conclusion

Awareness is reasonable amongst EM trainees but poor amongst surgeons. If the aims of the SSC are to be met, consideration must be given to differences in healthcare systems in different countries. In the United Kingdom, educational activities should be directed towards EM and surgical trainees as well as those working in intensive care.