beating sepsis in south america by machado
TRANSCRIPT
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