“The Severe Sepsis Bundles1 are designed to allow teams to follow the timing, sequence, and goals of the individual elements of care, in order to achieve the goal of a 25 percent reduction in mortality”.
What are the bundles and are they adapted to children? (see table).
Does their implementation reduce mortality? More than 15 studies conducted in adult emergency departments (ED) have demonstrated that having a sepsis programme significantly reduces mortality. In children, the first study applying the central venous oxygen saturation (ScvO2) goal-directed therapy confirmed the survival benefit.2
What are the potential barriers to their implementation? A recent survey in adult ED identified several barriers for nurses: lack of available nursing staff, challenges in identifying septic patients, difficulty of central catheter insertion and central venous pressure and ScvO2 monitoring in the ED and lack of physical space in the ED.
Sepsis benefits from rapid identification and treatment using the care bundles. Nurses working in ED and paediatric intensive care units do play a crucial role during each phase of the bundle implementation.