Breaking news from the Canadian Association of Emergency Physicians' annual meeting in Calgary, June 6-10, 2009.

CALGARY | Vancouver physicians have found that implementing a sepsis protocol in their emergency department was associated with a significant mortality benefit that remained even after two years.

In July 2005, Dr. Rob Stenstrom and colleagues at St. Paul's Hospital adopted an evidence-based protocol for early recognition and treatment of sepsis, including rapid antibiotics and I.V. fluids, rapid central line placement, and early goal-directed therapy started in the emergency department.

In a paper presented here at the Canadian Association of Emergency Physicians' annual meeting, Dr. Stenstrom compared mortality rates in 77 patients randomly selected from the period before protocol implementation and 87 from the period after implementation.

All patients were admitted to the intensive are unit from the emergency department with severe sepsis or septic shock and were followed for at least two years.

Both groups of patients were similar for age, gender distribution, severity scores and baseline lactate level.

Twenty-eight day mortality was 43.5% in the pre-protocol group and 24.4% in the protocol group; two-year mortality rates were 51.8% and 32.2%, respectively—differences that remained statistically significant after adjusting for confounding variables.