Study: Accuracy and Interobserver-Agreement of Respiratory Rate Measurements by Healthcare Professionals, and Its Effect on the Outcomes of Clinical Prediction/Diagnostic Rules

It has long been known that inter- and intra-assessor variability is a common finding in patient assessment by health professionals. This finding holds true both for subjective assessment, for example, estimating a patient’s weight; and objective assessment such as that highlighted here.

In the time-sensitive world of sepsis, few experts recommend that a formal calculation of SOFA score be attempted at the bedside. Instead, reliance is on clinical judgement assisted by ‘screening prompt’ scores aims at the detection of deterioration such as NEWS, MEWS, and qSOFA. Such schools are based on some evidence, and are one of our greatest assets in the battle against harm from deterioration. However, education around the use of these tools must recognize that they are only an adjunct: it is illogical, for example, to suggest that the thresholds for action around heart rate should be identical in an 18-year-old athlete and an 88-year-old with cardiorespiratory disease.

This study now highlights that our ability to reliably reproduce measurement is one of the most important markers of deterioration, respiratory rate, is impaired.

The potential impact of this variability for individual patients, as well as in improvement programs, is huge. Put simply, the variability between health professionals could make the difference between activating a sepsis pathway or not.

A key call to action arising from these findings, and applicable to all healthcare settings including in low- and middle-income countries, is that we get back to the basics and reinforce to health professionals the importance of using a timepiece to accurately record respiratory rate over a full minute.

For healthcare systems with access to technological solutions, this does also bring into question the appropriateness of infrequent intermittent observations. Continual physiological assessment, including assessment of the utility of wearable technology, could help to reduce variability and mitigate against harm. Studies have already shown that such systems have potential to reduce the time to recognition of deterioration.

This study is not transformational. What it does do is to reinforce to us the fact that we are reliant on the eyes and ears of health professionals around the world to activate treatment bundles for sepsis. It reminds us that there is variability even when trained professionals are assessing, and that repeated assessments and opportunities for juniors to request further review are essential steps in mitigating against harm arising from missing cases of sepsis.

Marvin Zick
Presentations from WSD Supporter Meeting at the World Congress of Intensive Care in Melbourne
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On Wednesday, October 16th, 2019, World Sepsis Day Supporters from all around the globe came together at the World Congress of Intensive Care in Melbourne, Australia, for a World Sepsis Day Supporter Meeting.

Simon Finfer, John Marshall, Flavia Machado, Ged Williams, Alison Fox-Robichaud, Djillali Annane, Abi Beane, Tony Yeh, Bala Venkatesh, Luregn Schlapbach, and Brett Abbenbroek provided an update on regional and national sepsis related activities. Presentations can be viewed and downloaded below (please note that not all presentations had slides). Topics included the strategy of the Global Sepsis Alliance for 2019 and 2020, a look back on World Sepsis Day, an update on the Asia Pacific Sepsis Alliance, African Sepsis Alliance, and Latin America Sepsis Institute, along with  recent achievements in the fight against sepsis in Canada, France, Taiwan, the Eastern Mediterranean, South East Asia, and Australia.

Our next World Sepsis Day Supporter Meeting will take place at ISICEM 2020 in Brussels, Belgium.

Summary of GSA and WSD Activities in 2019 - Flavia Machado and Simon Finfer

WHO Resolution on Sepsis - Progress - Flavia Machado and Simon Finfer

Asia Pacific Sepsis Alliance - Simon Finfer

Latin American Sepsis Institute - Flavia Machado

Sepsis in Taiwan - Tony Yeh

Queensland Sepsis Steering Committee – Bala Venkatesh

Pediatric Sepsis in Australia – Luregn Schlapbach

Marvin Zick
25th International Symposium on Infections in the Critically Ill Patient in Barcelona, Spain

On February 13 and 14th, 2020, the 25th International Symposium on Infections in the Critically Ill Patient will be held in Barcelona, Spain.

This will be the 25th anniversary of the symposium where more than 30 international recognized experts will review current concepts, technologies, and present advances in infections in critically ill patients. Sepsis, fluid and vasopressors, personalized and new treatments, pulmonary infections, new diagnostic tools, basic research, and treatment and prophylaxis of severe infections will be the topics of the main sessions.

At the end of each session, a clinical controversy and panel discussion will give you the option to interact with these leading experts in the field of infections.

Marvin Zick
French Ministry Issues Report - 10 Measures to Improve the Prevention, Diagnosis, and Management of Sepsis in France
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In May 2018, the French Director-General of Health, Prof. Jérôme Salomon, appointed Prof. Djillali Annane to write a report on improving the prevention, diagnosis, and management of sepsis in France.

Prof. Annane, recognized as one of the world’s leading experts on sepsis and member of the steering committee of the European Sepsis Alliance, worked with virtually all stakeholders in France, including many medical societies, to develop a comprehensive plan to action. Among the 10 recommendations made in the report, priority is given to raising awareness among the public and health professionals to detect the signs of sepsis as early as possible, as well as to implement a specific sepsis care pathway, adapted to all ages of life.

In 2017, the World Health Assembly and the World Health Organization made sepsis a global health priority by adopting a resolution to improve, prevent, diagnose, and manage sepsis. This resolution was spearheaded by the Global Sepsis Alliance and urges UN Member States to implement appropriate measures to reduce the human and health economic burden of sepsis.

This report on sepsis, and the fact that it was commissioned by the French Government, is a promising first step for France and hopefully serves as a blueprint for more countries to develop and implement comprehensive national action plans on sepsis. The GSA supports this process via its regional sepsis alliances and has both experience as well as dedicated staff to help implement national sepsis plans - please contact us if you or your organization is pursuing such plans.


About Sepsis

Sepsis arises when the body’s response to an infection injures its own tissues and organs. It may lead to shock, multi-organ failure, and death - especially if not recognized early and treated promptly. Sepsis is the final common pathway to death from most infectious diseases worldwide.

Marvin Zick
International Critical Care Nursing Considerations and Quality Indicators for the 2017 Surviving Sepsis Campaign Guidelines
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A new open access publication highlights the implications of the Surviving Sepsis Campaign Guidelines for nursing care. Four leading international critical care organizations, including the European Federation of Critical Care Nursing Associations (EfCCNa), the European Society of Intensive Care Medicine Nursing and Allied Healthcare Professionals Section, the Society of Critical Care Medicine (SCCM), and the World Federation of Critical Care Nurses (WFCCN) collaborated to outline considerations and quality indicators for nursing care based on the guidelines.

Marvin Zick
Presentations from WSD Supporter Meeting at ESICM LIVES 2019 in Berlin
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Yesterday, on Monday, September 30th, 2019, World Sepsis Day Supporters from all around the globe came together at ESICM LIVES 2019 for a World Sepsis Day Supporter Meeting.

Konrad Reinhart, Christiane Hartog, Adam Linder, Vida Hamilton, Hiroki Saito, Necmettin Unal, and Marvin Zick all held presentations, which you can view and download below. Topics were the strategy of the GSA for 2019 and 2020, the European Sepsis Alliance and its Working Groups, a look back on World Sepsis Day, and recent achievements in the fight against sepsis in Japan, Ireland, and Turkey.

Our next World Sepsis Day Supporter Meeting will take place on October 16th at the World Congress of Intensive Care in Melbourne, Australia.

GSA Achievements and Strategy for 2019/2020 - Konrad Reinhart

European Sepsis Alliance - Working Group Patients and Family Involvement - Christiane Hartog

Irish National Sepsis Programme Update 2019 - Vida Hamilton

Strategies to Fight Sepsis in Turkey - Necmettin Unal

Sepsis-Related Activities in Japan and the Japanese Sepsis Alliance - Hiroki Saito

Report on 2019 World Sepsis Day - Marvin Zick

Marvin Zick
Deadline Extended to October 9th: Submit Your Event and Picture for the 2019 WSD Event Poster
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Update September 30th, 2019: We have extended the deadline for uploads to Wednesday, October 9th, 2019. Please upload your event soon.

Original post, September 14th, 2019: Yesterday, September 13th, was World Sepsis Day. Countless events all over the world raised awareness for sepsis, the most preventable cause of death worldwide - thank you so much for participating.

Like in the previous years, we will summarize all events on the 2019 WSD Event Poster - please upload your event now, it takes less than a minute. The form closes on September 30th, please upload your event before that date.

Please note that you can only upload one picture per event (the poster gets too crowded otherwise) – please choose the best/the most representative one.

Since the poster will eventually be printed, we require the picture to be of a certain quality. If you get an error message saying the picture is too small, please double-check that you are uploading the original file without having accidentally compressed it. Compressing can happen when sending pictures through messengers, such as WhatsApp. In such a case, please get the original file from the person who took the picture, or ask that person to upload the picture directly. Uploads from mobile are possible.

Please use only the provided form to submit your events - we can’t use pictures that are emailed to us or sent through social media.

We plan to complete the poster by November, and we will make it available for download, as well as sent out printed copies, which you will be able to order free of charge as soon as the poster is completed.

Please point your colleagues and friends to our website to submit their events, especially if you know that they did an event for World Sepsis Day – thanks so much.

If you adhered to the instructions above and have problems, or for any questions, please contact us.

Marvin Zick
Project Presentation – How the '6th Annual Jeff Davis Sepsis Challenge 5K' Is Raising Awareness in the United States

In June, we announced the winners of the 2019 Global Sepsis Awards. In addition to the five winners, nine other entities were commended for their valuable contribution in the global fight against sepsis.

Over the coming months, we will give both the 2019 GSA Award Winners as well as the activities and initiatives by the entities that were commended the possibility to share their projects and initiatives in more detail on our websites, and after our colleagues from Italy in June and the project “Stop Sepsis in Croatia” in July, we would like to introduce you the ‘6th Annual Jeff Davis Sepsis Challenge 5K’ today.


The 6th Annual Jeff Davis Sepsis Challenge 5K


The 6th Annual Jeff Davis Sepsis Challenge 5K was held on June 29th, 2019 at Garfield Park in Indianapolis, Indiana. This was after 4 successful years in Colorado and 1 successful year in Illinois. The 5K had about 60 participants and raised about $2700 for Sepsis Alliance. We shared Jeff’s story,  Josslyn’s story, and Jonathin’s story. Josslyn’s family worked tirelessly to recently pass mandatory sepsis protocols, “Josslyn’s Law”, in the state of Indiana. They went into effect July 1. All together Lisa Bartlett has raised about $25,000 for Sepsis Alliance and was named a 2016 Sepsis Hero.


Lisa was recently on News 6 in Indianapolis and on the radio at HI-99 in Terre Haute, Indiana. She is still pursuing “Jeff’s Law” and has now focused her efforts in the state of Missouri. Jill Kogan Blake, 2018 Sepsis Hero, put 4 billboards up of Jeff in the San Francisco Bay Area. These are posted with a quiz teaching the public how much they really know about sepsis. Lisa put one billboard up in Southern Indiana, and one up by Ft. Campbell Army post in Tennessee. Jeff was a veteran.

As soon as the years 5K is over, she starts planning the next one. She is also an Advisory board member for Sepsis Alliance. Lisa will continue to work raising sepsis awareness around the globe until everybody in the US knows about sepsis.

Most recently, Lisa has started a petition to establish mandatory sepsis protocols in all healthcare facilities and declare September National Sepsis Awareness Month, for which she needs 100,000 signatures by October 27th.

The Global Sepsis Awards, which are sponsored by the Erin Kay Flatley Memorial Foundation, honor outstanding efforts to increase sepsis awareness and raise the quality of sepsis prevention and management.

The awards are granted in three categories, namely governments and healthcare authorities, non-governmental organizations, patient advocate or healthcare provider groups, and individuals, consistent with the aims of the World Sepsis Declaration and the World Sepsis Day Movement.

Winners in category II and III will receive $2,500 prize money each. Applications and nominations for the 2020 GSA Awards open in January 2020 and close on March 31st, 2020.

Marvin Zick