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Sepsis Protocols Effective in Reducing Mortality

In 2012, 12-year-old Rory Staunton died from undiagnosed sepsis, apparently related to a cut on his arm that had occurred while playing basketball. This led to new rules in New York, called Rory's Regulations. These regulations require New York hospitals to follow protocols regarding sepsis treatment protocols but allow some customization. Still, certain actions are required, including collecting a blood culture to test for infection and administering antibiotics and fluids within an hour to any child suspected of sepsis.

While this mandate was controversial, a recent study suggests the protocols are proving effective in reducing deaths from sepsis if medical professionals act quickly. Researchers analyzed the outcomes of 1,179 children with sepsis reported at 54 New York hospitals, including 139 who died. The children with sepsis averaged around 7 years of age, with 44.5% healthy before developing the critical illness.

The study authors noted that more than 10% of children hospitalized with sepsis die. However, the authors found the risk of death fell 40% if the sepsis protocol was completed within an hour. On the other hand, when only some of the protocol was met within an hour, the mortality risk remained elevated.

"It's clear that completing the entire sepsis protocol within an hour is associated with lower mortality," lead author Idris V.R. Evans, MD, explained. "But the mechanism of benefit still requires more study. Does each element of the protocol contribute to specific biologic or physiologic changes that, when combined, improve outcomes? Or is it that completion within an hour may simply be an indication of greater awareness by doctors and nurses caring for the child? Or could it be something else entirely?"

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