Pediatric shock carries a high morbidity and mortality, making early recognition key. Recently, pediatric critical care and resuscitation has been the focus of emergency department care improvement.

By shortening the duration of antibiotic therapy, a procalcitonin-guided protocol decreased the rate of infection-associated adverse effects, decreased costs, and reduced mortality in patient with sepsis.

A program that used nurse navigators with heart failure patients cut its 30-day readmission rate in half and provided more thorough follow-up care in transitioning patients home.

Short-term (< 14 days) administration of oral corticosteroids is associated with an increased risk of adverse events, including an approximately two-fold risk of sepsis.

In this analysis of California deliveries between 2008 and 2011, risk factors for maternal readmission for sepsis were found to include preterm birth, hemorrhage, obesity, and a primary cesarean delivery.

Sepsis remains a major healthcare problem associated with significant morbidity and mortality. Roles for hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT therapy) as potential adjuvants remain controversial.

Two double-blinded, placebo-controlled, randomized trials involving 337 patients (ORANGES, n = 137; ACTS, n = 200) with sepsis and septic shock have shown that administration of ascorbic acid, thiamine, and hydrocortisone did not reduce organ dysfunction or improve overall mortality. However, both trials showed that this combination therapy was effective in reducing the time to achieve shock resolution or shock-free days.

ICU deaths declined 2% steadily annually at non-minority hospitals, according to a recent report. This was not true of minority-serving hospitals. Those hospitals also reported longer lengths of stay and more critical illness than non-minority hospitals.

Compared with either score alone, using both SIRS and SOFA scores led to earlier and more complete recognition of sepsis in patients presenting to the emergency department.