beating sepsis in south america by machado

Beat The

BUGS

SEPSISIN

FLAVIAMACHADO

TRYING TO Beat

SEPSIS

IN

FLAVIAMACHADO

If you know your enemy and you know yourself you need not fear the results of a hundred of battles.

Sun Tzu

First major problem: absence of data

Sepsis OR severe sepsis OR septic shock AND

Name of the countryAND

Epidemiology OR mortality OR burden OR quality improvement OR clinical trial

Limited to 10 years 287

N = 1 27N = 0

98N = 4

829N = 3349

N = 0

0N = 0

94N = 6

20N = 0

0N = 0

0N = 0

First major problem: absence of data

SPREAD - Sepsis PREvalence Assessment Database

Mortality

: 55,7%

Lactate

Noradrenaline

Third major problem: ICU accessThe true map of access

3.019.9

3.517.4

1.78.1

3.645.8

2.935.4

2.027.6

5.226.7

8.532.0

3.027.2

3.733.8

4.425.3

5.537.7

6.422.9

5.618.4

7.732.4

3.727.8

9.816.8

12.318.9

7.521.6

7.847.9

5.525.9

12.460.8 7.5

15.26,.537.7

10.021.8

6.817.7

10.624.7

Per 100.000 habs

Cadastro Nacional dos Estabelecimentos de Saúde (CNES) – 2013, Agência Nacional de Saúde Suplementar (ANS) e Instituto Brasileiro de Geografia e Estatística (IBGE).

Third major problem: ICU accessThe true map of access

Cadastro Nacional dos Estabelecimentos de Saúde (CNES) – 2013, Agência Nacional de Saúde Suplementar (ANS) e Instituto Brasileiro de Geografia e Estatística (IBGE).

7.6 public ICU beds for 100,000 habitants

Middle-West7.4

Northeast5.0

North3.2

South9.4

Southest 10.4

25.5 private ICU beds for 100,000 habitants

Middle-West38.5

Northeast28.4

North28.8

South22.2

Southest 24.2

Which Brazil?

Mortality throughout the intervention according to the type of hospital

Latin America Sepsis Institute databaseIntervention: multifaceted sepsis protocol implementationPeriod: 2005-2014N = 21,203 patients

Fourth major problem: inadequate process of care

Latin America Sepsis Institute databaseIntervention: multifaceted sepsis protocol implementationPeriod: 2005-2014Only ER patientsN = 10,694 patients

Our worst scenario: public emergency services

Mortality throughout the intervention in patients from the emergency department according to the type of hospital

Have you ever hear the world sepsis?Body response to an infection 40%Blood poisoning 27%I don’t know 22%

AND

SEPSIS ROCK

SEPSY BACK Kern Medical Center

Percentage of positive answers to the question: “Have you ever heard the world sepsis?”

Alenanha Estados Unidos Canadá Brasil 0

10

20

30

40

50

60

49,0

44,0

29,0

6,6

Resp

osta

s pos

itiva

s %

Brazil

2.126 people134 citiesJune 2014

Fifth major problem: awareness

What is our number one priority?

What is our number one priority?

We should not only raise awareness but rather raise

passion

What is our number one priority?

We are in so different worlds…

Keep TRYING TO Beat

SEPSIS

IN